Individual provider Active NPI

Emily Ann Brooker, PA

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1114031457
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1850 N Central Ave Ste 1600
Phoenix, AZ 85004-4633
Phone
(602) 262-8900
Fax
(602) 262-8890
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1850 N Central Ave Ste 1600
Phoenix, AZ 85004-4633

Mailing address

1850 N Central Ave Ste 1600
Phoenix, AZ 85004-4633
Phone (602) 262-8900

Other practice location 1

9401 W Thunderbird Rd
Suite 180
Peoria, AZ 85381-4233
Phone (623) 516-8252

Other practice location 2

9401 W Thunderbird Rd
Suite 180
Peoria, AZ 85381-4233
Phone (623) 516-8252

Other identifiers 1

IdentifierTypeStateIssuer
712417MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20121022000820 AZ Practitioner - Physician Assistant 2668504291 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

Practice addresses (Care Compare)

16620 N 40TH St
Phoenix, AZ 85032-3350
Phone (480) 565-7246

25101 N Lake Pleasant Pkwy
Peoria, AZ 85383-1386
Phone (602) 610-6866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3485AZMDPsychologist

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GECCDD/Endpoint/GECCDD

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1114031457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-262-8900",
            "fax_number": "602-262-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850044633",
            "telephone_number": "602-262-8900",
            "fax_number": "602-262-8890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9401 W Thunderbird Rd",
            "address_2": "Suite 180",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853814233",
            "country_code": "US",
            "telephone_number": "623-516-8252",
            "fax_number": "623-516-8253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9401 W Thunderbird Rd",
            "address_2": "Suite 180",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853814233",
            "country_code": "US",
            "telephone_number": "623-516-8252",
            "fax_number": "623-516-8253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKER",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "712417",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.