Individual provider Active NPI

Brooke Hall, PA-C

  • Medical Physician Assistant
  • Tulsa, OK
National Provider Identifier
1275286254
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4701 Issued in OK
Practice address
10109 E 79TH St
Tulsa, OK 74133-4564
Phone
(918) 233-9550
Fax
(918) 300-1059
NPI assigned
Jan 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4701 OK Primary

Addresses

Primary practice location

10109 E 79TH St
Tulsa, OK 74133-4564

Mailing address

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 233-9550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220518002827 OK Practitioner - Physician Assistant 8224415922 Reassigns benefits to 1 organization
I20231120002229 TX Practitioner - Physician Assistant 8224415922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians

Practice addresses (Care Compare)

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333

Hospital & facility affiliations

  • Council Oak Comprehensive Healthcare Hospital, Tulsa, OK, CCN 370244
  • Creek Nation Community Hospital Hospital, Okemah, OK, CCN 371333
  • Muscogee (Creek) Nation Medical Center Hospital, Okmulgee, OK, CCN 370057

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
83.76
Promoting interoperability
100
Improvement activities
40
Cost
56.64

Merit-based Incentive Payment System (MIPS)

Final score
85.89 of 100Reported as group
Quality
73.2
Promoting interoperability
100
Improvement activities
40
Cost
79.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4701OKMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics CurrentSince Dec 4, 2023 Accepting new patients
Creek Nation Hospital & Clinics Past Accepting new patients

Locations

Dept 1467
Tulsa, OK 74182

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

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.

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": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1275286254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10109 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334564",
            "telephone_number": "918-233-9550",
            "fax_number": "918-300-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10109 E 79TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741334564",
            "telephone_number": "918-233-9550",
            "fax_number": "918-300-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "4701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.