NPIMap

Individual provider Active NPI

Melissa Ann Brooks, MSN, FNP

  • Family Nurse Practitioner
  • Grand Marais, MN
National Provider Identifier
1073893772
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9258 Issued in MN
Practice address
513 5TH Ave W
Grand Marais, MN 55604-3017
Phone
(218) 387-2330
Fax
(218) 387-2330
NPI assigned
Aug 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1391 AK
Family Nurse Practitioner 363LF0000X 9258 MN Primary

Addresses

Primary practice location

513 5TH Ave W
Grand Marais, MN 55604-3017

Mailing address

513 5TH Ave W
Grand Marais, MN 55604-3017
Phone (218) 387-2330

Other practice location 1

602 Chase Ave
Cordova, AK 99574
Phone (907) 424-8240 ext. 240

Other practice location 2

358 N Main St
Colville, WA 99114-2310
Phone (509) 684-1440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160129000137 TX Practitioner - Nurse Practitioner 4587899125 Reassigns benefits to 1 organization
I20220927002602 MN Practitioner - Nurse Practitioner 4587899125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
Sawtooth Mountain Clinic IncGroup PAC ID 8224940010, 13 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

513 5TH Ave W
Grand Marais, MN 55604-3017
Phone (218) 387-2330

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
1391AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 6, 2015 Accepting new patients
Sawtooth Mountain Clinic, Inc. CurrentSince May 20, 2022 Accepting new patients
South East Alaska Regional Health Consortium CurrentSince Oct 6, 2015 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
The Duluth Clinic, LTD. PastSince May 20, 2022 Accepting new patients
Southeast Alaska Regional Health Consortium Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients
South East Alaska Regional Health Consortium Past Accepting new patients

Locations

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

3260 Hospital Dr
Juneau, AK 99801
Phone (907) 796-8427

2000 Salmon Creek Ln
Juneau, AK 99801
Phone (907) 463-8700

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8519

513 5th Ave W
Grand Marais, MN 55604
Phone (218) 387-2330

Interoperability endpoints

  • Direct secure messaging: mbrooks815103@direct.ochin.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1073893772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 5TH AVE W",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556043017",
            "telephone_number": "218-387-2330",
            "fax_number": "218-387-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 5TH AVE W",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556043017",
            "telephone_number": "218-387-2330",
            "fax_number": "218-387-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Chase Ave",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "AK",
            "postal_code": "99574",
            "country_code": "US",
            "telephone_number": "907-424-8240 x240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "358 N Main St",
            "address_purpose": "LOCATION",
            "city": "Colville",
            "state": "WA",
            "postal_code": "991142310",
            "country_code": "US",
            "telephone_number": "509-684-1440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "MSN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AK",
            "license": "1391",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Marais, MN

Sources for this page

Verify at the official NPI Registry.