Trevor Brodsky-Brooks, M.D.
Individual provider Active NPI Family Medicine Physician · Walnut Creek, CA
NPI 1407389331 · NPPES record last updated Sep 20, 2023
Key facts
- NPI
- 1407389331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A158949 (CA)
- Practice address
- 1425 S Main St
Walnut Creek, CA 94596-5318 - Phone
- (925) 295-4000
- NPI assigned
- Apr 7, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of California, San Francisco School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Permanente Medical Group Inc
Practice addresses (Care Compare)
1425 S Main St
Walnut Creek, CA 94596-5318
Phone (925) 295-4000
Hospital & facility affiliations
- Kaiser Foundation Hospital - Walnut Creek
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201026001613 | CA | Practitioner - Family Practice | 5092135327 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A158949 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pih Health Physicians | Family Medicine | Current | Accepting new patients |
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Pih Health Physicians | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Family Medicine | Current | Accepting new patients |
| Permanente Medical Group Inc | Family Medicine | Current |
Accepting new patients |
| Pih Health Physicians | Current |
Accepting new patients |
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738
900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014
12675 La Mirada Blvd
Ste 201401
La Mirada, CA 90638
Phone (562) 903-7339
101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
930 W Main St
Ripon, CA 95366
Phone (209) 599-4221
501 J St
Sacramento, CA 95814
Phone (916) 497-3000
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
1425 S Main St
Walnut Creek, CA 94596
Phone (925) 295-4130
12401 Washington Blvd
Whittier, CA 90602
Phone (562) 698-0611
15725 Whittier Blvd
Whittier, CA 90603
Phone (562) 448-1350
6557 Greenleaf Ave
Whittier, CA 90601
Phone (562) 789-5401
320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A158949 | CA | Yes |
Addresses
Primary practice location
1425 S Main St
Walnut Creek, CA 94596-5318
Mailing address
1425 S Main St
Walnut Creek, CA 94596-5318
Phone (925) 295-4000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
Other providers in Walnut Creek, CA
- Broadway Dmes LLC
- Broadways DME LLC
- Michele Anthony Brocato
- Casey David Brodhead
- Jennifer Brodie
- Danica Nicole Brogdon
- Jared Brogdon
- Susan Gail Brogdon
- Hannah Bronsky Pena
- Elizabeth Marie Bronson
All providers in Walnut Creek, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.