NPIMap

Individual provider Active NPI

Brooke Mae Elliott, PA-C

  • Medical Physician Assistant
  • Vancouver, WA
National Provider Identifier
1285816264
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10005303 Issued in WA
Practice address
14201 NE 20TH Ave Ste 3103
Vancouver, WA 98686-6414
Phone
(360) 571-9799
Fax
(360) 576-6320
NPI assigned
Nov 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10332 OR
Medical Physician Assistant 363AM0700X PA10005303 WA Primary

Addresses

Primary practice location

14201 NE 20TH Ave Ste 3103
Vancouver, WA 98686-6414

Mailing address

2101 NE 139TH St
Ste 450
Vancouver, WA 98686-2325
Phone (360) 904-6694

Other practice location 1

9430 NE Vancouver Mall Dr
Vancouver, WA 98662-6172
Phone (360) 253-6947

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090928000691 WA Practitioner - Physician Assistant 3870649106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

2101 NE 139TH St
Suite 460
Vancouver, WA 98686-2325
Phone (360) 487-2727

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

Hospital & facility affiliations

  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10332ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Jun 4, 2019 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jun 4, 2019 Accepting new patients

Locations

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

2101 NE 139th St
Ste 450
Vancouver, WA 98686
Phone (360) 487-4848

2101 NE 139th St
Ste 460
Vancouver, WA 98686
Phone (360) 487-2727

Interoperability endpoints

  • Direct secure messaging: belliott17424@direct.lhs.org

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 and National Provider Directory roles.

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": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1285816264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST",
            "address_2": "STE 450",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862325",
            "telephone_number": "360-904-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 NE 20TH AVE STE 3103",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866414",
            "telephone_number": "360-571-9799",
            "fax_number": "360-576-6320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9430 NE Vancouver Mall Dr",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986626172",
            "country_code": "US",
            "telephone_number": "360-253-6947",
            "fax_number": "360-448-6324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "BROOKE",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA10332",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10005303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.