Individual provider Active NPI

Brooks Carlton Michaels, MD

  • Family Medicine Physician
  • Simi Valley, CA
National Provider Identifier
1316930480
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G60910 Issued in CA
Practice address
2045 Royal Ave Ste 234
Simi Valley, CA 93065-4600
Phone
(805) 578-9751
Fax
(805) 578-2821
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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 G60910 CA Primary

Addresses

Primary practice location

2045 Royal Ave Ste 234
Simi Valley, CA 93065-4600

Mailing address

2045 Royal Ave Ste 234
Simi Valley, CA 93065-4600
Phone (805) 578-9751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G60910CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Miramar Eye Specialists Medical Group, Inc CurrentSince Jun 1, 2022 Accepting new patients

Locations

2045 Royal Ave
Ste 234
Simi Valley, CA 93065
Phone (805) 527-1417

Organizations & group practices 1

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1316930480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 ROYAL AVE STE 234",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654600",
            "telephone_number": "805-578-9751",
            "fax_number": "805-578-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 ROYAL AVE STE 234",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654600",
            "telephone_number": "805-578-9751",
            "fax_number": "805-578-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "BROOKS",
        "middle_name": "CARLTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G60910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.