Individual provider Active NPI

Joseph Gaius Brooks, PHD

  • Psychologist
  • Albuquerque, NM
National Provider Identifier
1164510434
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
701 Issued in NM
Practice address
8300 Constitution Ave NE
Albuquerque, NM 87110-7613
Phone
(505) 291-2770
Fax
(505) 291-2706
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 701 NM Primary

Addresses

Primary practice location

8300 Constitution Ave NE
Albuquerque, NM 87110-7613

Mailing address

PO Box 26666
Presbyterian Healthcare Services
Albuquerque, NM 87125-6666

Other identifiers 2

IdentifierTypeStateIssuer
00JA91OtherNMBCBS
00033197MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151104000468 NM Practitioner - Clinical Psychologist 8628388667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zia Community Cares, LLCGroup PAC ID 9830510288, 6 clinicians

Practice addresses (Care Compare)

5400 Gibson Blvd SE
Box 18
Albuquerque, NM 87108-4729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
701NMMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Zia Community Cares, LLC Psychologist CurrentSince May 30, 2020 Accepting new patients

Locations

5400 Gibson Blvd SE
Ste 11
Albuquerque, NM 87108
Phone (505) 832-7141

5400 Gibson Blvd SE
Ste 3B200
Albuquerque, NM 87108

1610 San Pedro Dr NE
Albuquerque, NM 87110

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1164510434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PRESBYTERIAN HEALTHCARE SERVICES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CONSTITUTION AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107613",
            "telephone_number": "505-291-2770",
            "fax_number": "505-291-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JOSEPH",
        "middle_name": "GAIUS",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00JA91",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00033197",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.