Individual provider Active NPI

Brian Joseph Brooke, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1144405382
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C03635 Issued in MD
Practice address
6565 N Charles St Ste 601
Baltimore, MD 21204-5801
Phone
(410) 821-5151
NPI assigned
Jan 7, 2008
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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 C03635 MD Primary

Addresses

Primary practice location

6565 N Charles St Ste 601
Baltimore, MD 21204-5801

Mailing address

6565 N Charles St Ste 601
Baltimore, MD 21204-5801
Phone (410) 821-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20090529000342 MD Practitioner - Physician Assistant 8527117225 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Centers for Advanced ENT Care LLCGroup PAC ID 1658647359, 103 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

6565 N Charles St
Suite 601
Baltimore, MD 21204-5801
Phone (410) 821-5151

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C03635MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Nov 1, 2023 Accepting new patients
Cep America LLC CurrentSince Nov 1, 2023 Accepting new patients
Cumberland Valley ENT Consultants Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

6701 N Charles St
Towson, MD 21204
Phone (443) 849-2000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1144405382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 N CHARLES ST STE 601",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212045801",
            "telephone_number": "410-821-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 N CHARLES ST STE 601",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212045801",
            "telephone_number": "410-821-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKE",
        "first_name": "BRIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-07",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C03635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.