Individual provider Active NPI

Judith C Brooks, M.D.

  • Family Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1235398025
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME1190915 Issued in FL
Practice address
1701 SE Hillmoor Dr Ste B9
Port St Lucie, FL 34952-7540
Phone
(772) 348-0303
Fax
(772) 348-0307
NPI assigned
Jun 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME1190915 FL Primary

Addresses

Primary practice location

1701 SE Hillmoor Dr Ste B9
Port St Lucie, FL 34952-7540

Mailing address

1701 SE Hillmoor Dr Ste B9
Port Saint Lucie, FL 34952-7540
Phone (772) 348-0303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20130529000724 FL Practitioner - Family Practice 2466690649 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1701 SE Hillmoor Dr
Suite B9
Port Saint Lucie, FL 34952-7540
Phone (772) 348-0303

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME1190915FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lucie Medical Specialists LLC Family Medicine CurrentSince May 1, 2014 Accepting new patients
South Palm Family Center Family Medicine CurrentSince Jan 1, 2022 Accepting new patients

Locations

2505 SW Martin Hwy
Palm City, FL 34990
Phone (772) 288-0060

1701 SE Hillmoor Dr
Ste B9
Port St Lucie, FL 34952
Phone (772) 348-0303

140 SW Chamber Ct
Ste 100
Port St Lucie, FL 34986
Phone (772) 873-0303

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1235398025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 SE HILLMOOR DR STE B9",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527540",
            "telephone_number": "772-348-0303",
            "fax_number": "772-348-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SE HILLMOOR DR STE B9",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527540",
            "telephone_number": "772-348-0303",
            "fax_number": "772-348-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JUDITH",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME1190915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.