Shane Op Brooks, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OP00001839 Issued in WA

Practice address

450 S Kitsap Blvd
#100
Port Orchard, WA 98366-3773

Phone

(360) 744-6275

Fax

(360) 895-6296

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Group practices

American Current Care of Washington PSGroup PAC ID 8022356617, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• American Current Care of Washington, P.S.

  • Urgent Care Clinic/Center
  • Seattle, WA
  • NPI 1073096871
  Medicare reassignment Care Compare group NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• American Current Care of Washington, P.S.

  • Urgent Care Clinic/Center
  • Spokane, WA
  • NPI 1881177681
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Covington, WA
  • NPI 1093768657
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1154364115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD",
            "address_2": "#100",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663773",
            "telephone_number": "360-744-6275",
            "fax_number": "360-895-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD",
            "address_2": "#100",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663773",
            "telephone_number": "360-744-6275",
            "fax_number": "360-895-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "SHANE",
        "middle_name": "OP",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP00001839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "2165BR",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0181442",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8326985",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0171367",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "1594BR",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "2264BR",
            "identifier": "BSWA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Mae Brezler, LMP
• Carol Mae Brigham, SUDP
• Erin Rene' Broadway, MS CCC SLP
• Mitchell D Brockett, OD
• Elizabeth Ann Brodie-Knope, PT
• McKinzey Lane Bross
• Amber Brown, LMP
• Anthony Jon Brown
• Hailee Kathleen Brown
• Leslie Brown, ARNP

• Emergency Medicine Physician in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.