Individual provider Active NPI

Tera C Brooks, M.D.

  • Family Medicine Physician
  • Kyle, TX
National Provider Identifier
1245504380
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R8322 Issued in TX
Practice address
4100 Everett Dr Ste 400
Kyle, TX 78640-6147
Phone
(512) 295-1333
Fax
(512) 406-7327
NPI assigned
Mar 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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 R8322 TX Primary

Addresses

Primary practice location

4100 Everett Dr Ste 400
Kyle, TX 78640-6147

Mailing address

4515 Seton Center Pkwy Ste 215
Austin, TX 78759-5785

Other identifiers 3

IdentifierTypeStateIssuer
27439OtherNENEBRASKA STATE LICENSE
388879401MedicaidTX
388879402MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180920002836 TX Practitioner - Family Practice 8527319144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

6835 Austin Ctr Blvd
Austin, TX 78731-3166
Phone (512) 346-6611

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R8322TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA Family Medicine CurrentSince Sep 6, 2018 Accepting new patients
Seton Family of Doctors Family Medicine CurrentSince Nov 1, 2019 Accepting new patients
Seton Family of Doctors CurrentSince Nov 1, 2019 Accepting new patients
Austin Regional Clinic, PA CurrentSince Sep 6, 2018 Accepting new patients

Locations

4515 Seton Center Pkwy
Ste 215
Austin, TX 78759
Phone (512) 338-3802

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

4100 Everett
Ste 400
Kyle, TX 78640
Phone (512) 295-1333

Interoperability endpoints

  • Direct secure messaging: tbrooks20470@arcmd.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1245504380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 SETON CENTER PKWY STE 215",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 EVERETT DR STE 400",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786406147",
            "telephone_number": "512-295-1333",
            "fax_number": "512-406-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "TERA",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R8322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEBRASKA STATE LICENSE",
            "identifier": "27439",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388879401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388879402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kyle, TX

Sources for this page

Verify at the official NPI Registry.