NPIMap

Individual provider Active NPI

Brooke A. Perez, PA-C

  • Physician Assistant
  • Coopers Mills, ME
National Provider Identifier
1114321882
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1489 Issued in ME
Practice address
47 Main St
Coopers Mills, ME 04341-4047
Phone
(207) 549-7581
Fax
(207) 549-3439
NPI assigned
Oct 9, 2014
Last updated
Apr 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1489 ME Primary
Medical Physician Assistant 363AM0700X PA1489 ME
Surgical Physician Assistant 363AS0400X PA1489 ME

Addresses

Primary practice location

47 Main St
Coopers Mills, ME 04341-4047

Mailing address

PO Box 727
Waterville, ME 04903-0727
Phone (207) 549-7581

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150116000145 ME Practitioner - Physician Assistant 8628392891 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4 Clement Way
Belgrade, ME 04917-4370
Phone (207) 660-9924

47 Main St
Cooper Mills, ME 04341
Phone (207) 549-7581

47 Main St
Sheepscot Valley HLT
Coopers Mills, ME 04341-0207
Phone (207) 549-7581

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
State of Maine CurrentSince Dec 5, 2017 Accepting new patients
Healthreach Community Health Centers CurrentSince Feb 13, 2023 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Healthreach Community Health Centers CurrentSince Feb 13, 2023 Accepting new patients
Mainehealth Past Accepting new patients
Healthreach Community Health Centers Past Accepting new patients
Healthreach Community Health Centers PastSince Apr 9, 2023 Accepting new patients

Locations

109 Capitol St
#11
Augusta, ME 04330

656 State St
Bangor, ME 04401
Phone (207) 941-4000

4 Clement Way
Belgrade, ME 04917
Phone (207) 660-9924

24 Miles Center Way
Damariscotta, ME 04543
Phone (207) 563-4250

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

49 Hooper St
Wiscasset, ME 04578
Phone (207) 882-7600

Interoperability endpoints

  • Direct secure messaging: bperez114079@direct.mmc.mainehealth.org

Organizations & group practices 11

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1114321882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 727",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049030727",
            "telephone_number": "207-549-7581",
            "fax_number": "207-549-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MAIN ST",
            "city": "COOPERS MILLS",
            "state": "ME",
            "postal_code": "043414047",
            "telephone_number": "207-549-7581",
            "fax_number": "207-549-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "BROOKE",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1489",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA1489",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ME",
            "license": "PA1489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coopers Mills, ME

Sources for this page

Verify at the official NPI Registry.