Benjamin Brock, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1196 Issued in AL

Practice address

5 Mobile Infirmary Cir
Mobile, AL 36607-3513

Phone

(251) 435-7289

NPI assigned

Jan 16, 2017

Last updated

Jan 16, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Imc-Hospitalists LLCGroup PAC ID 2264727155, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mobile Infirmary Medical Center Hospital, Mobile, AL, CCN 010113

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Imc-Hospitalists LLC

  • Hospitalist Physician
  • Mobile, AL
  • NPI 1669824934
  Medicare reassignment Care Compare group
• Inpatient Consultants of Alabama, Inc

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1235238916
  Medicare reassignment

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

• Mobile Infirmary Association

  dba Mobile Infirmary Medical Center

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1558364802
  Care Compare affiliation

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

{
    "created_epoch": "1484524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1083150940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 SPRING HILL AVE",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041402",
            "telephone_number": "251-435-1366",
            "fax_number": "251-435-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MOBILE INFIRMARY CIR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073513",
            "telephone_number": "251-435-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "BENJAMIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-16",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "1196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broad Street Health Inc (Ladas Pharmacy)
• Courtney Kuehn Broadfoot, CCC-SLP
• William Eric Broadfoot, MD
• Justin Broadhead, DO
• Alexandra J Brock
• Berkley Laurel Brock
• Cameron Leighton Brock, PA-S
• Catherine Wesson Brock, O.T.R./L
• Larry Dale Brock, M.D
• Harmony Rae Brogden, PA

• Physician Assistant in Mobile, AL
• Providers in Mobile, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.