Individual provider Active NPI

Carolyn E. Brooks, M.D.

  • Diagnostic Radiology Physician
  • Chicopee, MA
National Provider Identifier
1205875515
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
72356 Issued in MA
Practice address
444 Montgomery St
Chicopee, MA 01020-1969
Phone
(413) 594-3111
Fax
(413) 789-8034
NPI assigned
Jun 5, 2006
Last updated
Feb 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 72356 MA Primary

Addresses

Primary practice location

444 Montgomery St
Chicopee, MA 01020-1969

Mailing address

444 Montgomery St
Chicopee, MA 01020-1969
Phone (413) 594-3111

Other identifiers 1

IdentifierTypeStateIssuer
3075486MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20050413000889 MA Practitioner - Diagnostic Radiology 3476590209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Geisel School of Medicine at Dartmouth, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

444 Montgomery St
Chicopee, MA 01020-1969
Phone (413) 594-3111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Jul 1, 2016 Accepting new patients
Riverbend Medical Group, Inc. Diagnostic Radiology CurrentSince Jul 1, 2016 Accepting new patients
Providence Diagnostic Imaging, Inc. Diagnostic Radiology Past Accepting new patients
Riverbend Medical Group, Inc Past Accepting new patients

Locations

444 Montgomery St
Chicopee, MA 01020
Phone (413) 594-3111

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

395 Southampton Rd
Ste 100
Westfield, MA 01085
Phone (413) 485-4661

Interoperability endpoints

  • Direct secure messaging: cbrooks3001665@direct.trinity-health.org

Organizations & group practices 4

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1205875515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 MONTGOMERY ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010201969",
            "telephone_number": "413-594-3111",
            "fax_number": "413-789-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 MONTGOMERY ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010201969",
            "telephone_number": "413-594-3111",
            "fax_number": "413-789-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "CAROLYN",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "72356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3075486",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicopee, MA

Sources for this page

Verify at the official NPI Registry.