Individual provider Active NPI

Brooke Morgan Adema

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1205652195
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601013182 Issued in MI
Practice address
259 Mack Ave Ste 2590
Detroit, MI 48201-2427
Phone
(313) 577-1716
NPI assigned
Nov 25, 2024
Last updated
May 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601013182 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

259 Mack Ave Ste 2590
Detroit, MI 48201-2427

Mailing address

259 Mack Ave Ste 2590
Detroit, MI 48201-2427

Other practice location 1

6310 Sashabaw Rd Ste C
Clarkston, MI 48346-2270
Phone (248) 297-5282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250604000725 MI Practitioner - Physician Assistant 0941719645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pine Knob Urgent Care PLLCGroup PAC ID 8921307554, 6 clinicians

Practice addresses (Care Compare)

6310 Sashabaw Rd
Suite C
Clarkston, MI 48346-2270
Phone (248) 297-5282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1205652195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 MACK AVE STE 2590",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 MACK AVE STE 2590",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012427",
            "telephone_number": "313-577-1716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6310 Sashabaw Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483462270",
            "country_code": "US",
            "telephone_number": "248-297-5282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADEMA",
        "first_name": "BROOKE",
        "middle_name": "MORGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013182",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.