Individual provider Active NPI

Brooke Eryn Levine, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1306560107
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA63955 Issued in CA
Practice address
11611 San Vicente Blvd
Los Angeles, CA 90049-5106
Phone
(818) 477-7207
NPI assigned
Sep 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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 PA63955 CA Primary

Addresses

Primary practice location

11611 San Vicente Blvd
Los Angeles, CA 90049-5106

Mailing address

11611 San Vicente Blvd
Los Angeles, CA 90049-5106
Phone (818) 477-7207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260304003271 CA Practitioner - Physician Assistant 2466934823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brentview Medical IncGroup PAC ID 6608990742, 11 clinicians

Practice addresses (Care Compare)

11611 San Vicente Blvd
Los Angeles, CA 90049-5106
Phone (310) 820-0013

8264 Santa Monica Blvd
West Hollywood, CA 90046-5915
Phone (323) 522-2222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63955CAMDPharmacist
PA63955CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brentview Medical Inc. CurrentSince Dec 21, 2025 Accepting new patients
Brentview Medical Inc. CurrentSince Dec 21, 2025 Accepting new patients

Locations

11611 San Vicente Blvd
Los Angeles, CA 90049
Phone (310) 447-6060

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.

NPI Registry JSON

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1306560107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11611 SAN VICENTE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495106",
            "telephone_number": "818-477-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11611 SAN VICENTE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495106",
            "telephone_number": "818-477-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "BROOKE",
        "middle_name": "ERYN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.