Brian P. Brocker M.D., Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

35-066899 Issued in OH

Legal business name

BRIAN P. BROCKER M.D., INC

Practice address

1616 Covington St
Youngstown, OH 44510-1244

Phone

(330) 747-9215

Fax

(330) 747-9248

NPI assigned

Sep 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brian P. Brocker, M.D.NPI 1578548830

Title

President/Owner

Phone

(330) 747-9215

Specialties & licenses 1

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian P Brocker, M.D.

  • Neurological Surgery Physician
  • Youngstown, OH
  • NPI 1578548830
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1134316664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 COVINGTON ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101244",
            "telephone_number": "330-747-9215",
            "fax_number": "330-747-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 COVINGTON ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445101244",
            "telephone_number": "330-747-9215",
            "fax_number": "330-747-9248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN P. BROCKER M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "BROCKER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "330-747-9215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-066899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7405468",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-YNGS",
            "identifier": "9282452",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4597438",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0600127",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL-WARREN LOC",
            "identifier": "285520215005",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL MUTUAL-YNGS LOC",
            "identifier": "285520215001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000138342",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215672",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1507678",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC PROVIDER #",
            "identifier": "28552021500",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000106032",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-WARREN",
            "identifier": "9282451",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquelin Anne Brennan, MED
• Julie B Brennan, CNP
• Christine M Brent, P.T.
• John J. Brescia, M.A.
• Chad Breznak, APRN-CNP
• Melissa Ann Brian, NP
• Maegan Briant
• Nancy Ann Brickley, RN
• David Bridgeforth
• Bridgeway Family Services LLC

• Specialist in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.