Individual provider Active NPI

Brooke A Pierson, PA

  • Physician Assistant
  • Burr Ridge, IL
National Provider Identifier
1215289137
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-004424 Issued in IL
Practice address
901 McClintock Drive
Suite 202
Burr Ridge, IL 60527-0872
Phone
(888) 220-6432
Fax
(630) 654-4253
NPI assigned
Oct 3, 2012
Last updated
May 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-004424 IL Primary

Addresses

Primary practice location

901 McClintock Drive
Suite 202
Burr Ridge, IL 60527-0872

Mailing address

901 McClintock Drive
Suite 202
Burr Ridge, IL 60527-0872
Phone (888) 220-6432

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20121109000624 IL Practitioner - Physician Assistant 1951552488 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Affiliated Oncologists LLCGroup PAC ID 2365606563, 43 clinicians

Practice addresses (Care Compare)

10604 Southwest Hwy
Suite 109
Chicago Ridge, IL 60415-2717
Phone (708) 424-9710

3825 Highland Ave
Suite 307
Downers Grove, IL 60515-1562
Phone (708) 422-3242

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-5475

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-004424ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Anesthesiologists Chicago LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: brooke.pierson@affiliatedoncologists.ikm.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1215289137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DRIVE",
            "address_2": "SUITE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270872",
            "telephone_number": "888-220-6432",
            "fax_number": "630-654-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DRIVE",
            "address_2": "SUITE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270872",
            "telephone_number": "888-220-6432",
            "fax_number": "630-654-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSON",
        "first_name": "BROOKE",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-004424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burr Ridge, IL

Sources for this page

Verify at the official NPI Registry.