Tristan Brooks, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS16117 Issued in FL

Practice address

5100 N 12TH Ave Ste 201
Pensacola, FL 32504-8919

Phone

(850) 437-8485

NPI assigned

May 18, 2017

Last updated

Apr 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Psgfl MSSP, LLC

  • Multi-Specialty Clinic/Center
  • Gulf Breeze, FL
  • NPI 1689557936
  NPD

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1376070516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17567",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325227567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 N 12TH AVE STE 201",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048919",
            "telephone_number": "850-437-8485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Hodges Dr",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323084614",
            "country_code": "US",
            "telephone_number": "850-431-5430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "TRISTAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS16117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108191300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ellyn Brooks, PHD
• K. Glenn Brooks, DDS, MS
• Paul Davis Brooks, DPM
• Susan Brooks, L.M.T.
• Timothy Duane Brooks, M.D.
• Isabella Brookshier
• Clara Pauline Brosnaham, LMT, NCBTMB
• John Broussard, PT
• Roberta Ruth Broussard, LMT
• Anginette Richelle Browder, NP-C

• Family Medicine Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.