Ilaisiah Brooks, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

355878 Issued in NY

Practice address

111 Church Dr
Mastic Beach, NY 11951-1801

Phone

(631) 504-2618

Fax

(631) 504-2618

NPI assigned

Mar 16, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1417804667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHURCH DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119511801",
            "telephone_number": "631-504-2618",
            "fax_number": "631-504-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CHURCH DR",
            "city": "MASTIC BEACH",
            "state": "NY",
            "postal_code": "119511801",
            "telephone_number": "631-504-2618",
            "fax_number": "631-504-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "ILAISIAH",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "355878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jermaine Bent
• Ailyn Bharath, LPN
• Janelle Florence Biegert, LPN
• Amanda Marie Boyce, LPN
• Marie F Braccia, P.T.
• Marissa Brooks, L.P.N
• Jennifer Bryant, LPN
• Ariel Louise Bukzin, LMSW
• Kyra M Burton
• Stacey Lynne Busching, LPN

• Licensed Practical Nurse in Mastic Beach, NY
• Providers in Mastic Beach, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.