Jason Brooks, MD
Individual provider Active NPI Family Medicine Physician · Palmer, AK
NPI 1164465712 · NPPES record last updated Mar 12, 2014
Key facts
- NPI
- 1164465712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4291 (AK)
- Practice address
- 634 S Bailey St
Ste 104
Palmer, AK 99645-6330 - Phone
- (907) 746-2345
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Oregon Health Sciences University School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
258 S Alaska St
Palmer, AK 99645-6334
Phone (907) 746-2345
Hospital & facility affiliations
- Mat-Su Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 11 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040902001362 | AK | Practitioner - Family Practice | 8628044450 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4291 | AK | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palmer Family Medicine Inc | Family Medicine | Current |
Accepting new patients |
| Mat-Su Valley Medical Center LLC | Past | Accepting new patients | |
| Medical Network of Alaska, LLC | Past | Accepting new patients | |
| Alaska Physician Services,LLC | Past | Accepting new patients |
Locations
634 S Bailey St
Ste 104
Palmer, AK 99645
Phone (907) 521-2888
258 S Alaska St
Palmer, AK 99645
Phone (907) 745-2345
634 S Bailey St
Palmer, AK 99645
Phone (907) 376-9091
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/AACCAA/Endpoint/AACCAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4291 | AK | Yes |
Addresses
Primary practice location
634 S Bailey St
Ste 104
Palmer, AK 99645-6330
Mailing address
634 S Bailey St
Ste 104
Palmer, AK 99645-6330
Phone (907) 746-2345
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1019926 | Medicaid | AK |
Other providers in Palmer, AK
- Jenifer Breiner
- Brent H Taylor, MD LLC
- Dawn Brickel
- Valerie L Brock
- Garland Brooks
- Grace Brown
- Rebecca Browning
- Dane Sidney Brubaker
- Bruck Clift MD LLC
- Kolten W Brueggeman
All providers in Palmer, AK · Family Medicine Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.