Individual provider Active NPI

Charles Douglas Brooks, MD

  • Diagnostic Radiology Physician
  • Amarillo, TX
National Provider Identifier
1427231638
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35.092843 Issued in OH
Practice address
1901 Medi Park Dr
Suite 2050
Amarillo, TX 79106-2110
Phone
(806) 355-3352
Fax
(806) 355-5367
NPI assigned
Dec 11, 2007
Last updated
Sep 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M7874 TX
Diagnostic Radiology Physician 2085R0202X 35.092843 OH Primary
Diagnostic Radiology Physician 2085R0202X MD2010-0147 NM

Addresses

Primary practice location

1901 Medi Park Dr
Suite 2050
Amarillo, TX 79106-2110

Mailing address

1901 Medi Park Dr
Suite 2050
Amarillo, TX 79106-2110
Phone (806) 355-3352

Other identifiers 3

IdentifierTypeStateIssuer
35.092843OtherOH35.092843
M7874OtherTXTX LIC# M7874
MD2010-0147OtherNMNEW MEXICO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080118000007 TX Practitioner - Diagnostic Radiology 9234210022 Reassigns benefits to 2 organizations
I20141110001205 NM Practitioner - Diagnostic Radiology 9234210022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Texas Tech University Health Science Center School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
High Plains Radiological Association LLPGroup PAC ID 9739172479, 36 clinicians
Open Air Imaging Center LLPGroup PAC ID 9739258310, 25 clinicians

Practice addresses (Care Compare)

117 Camina de Vida
Santa Rosa, NM 88435-2259
Phone (575) 472-3417

117 E 19TH St
Roswell, NM 88201-5151
Phone (575) 627-7000

1901 Medi Park Dr
Suite 2050
Amarillo, TX 79106-2109
Phone (806) 355-3352

7400 Wallace Blvd
Amarillo, TX 79106-1818
Phone (806) 353-8333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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
35.092843OHMDDiagnostic Radiology Physician
M7874TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
High Plains Radiological Association LLP Diagnostic Radiology CurrentSince Jun 1, 2010 Accepting new patients
Open Air Imaging Center, LLP CurrentSince Oct 1, 1993 Accepting new patients
Osu Radiology LLC Diagnostic Radiology PastSince Oct 1, 2005 Accepting new patients

Locations

117 Camino de Vida
Santa Rosa, NM 88435
Phone (575) 472-3417

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

1901 Medi Park Dr
Ste 2050
Amarillo, TX 79106
Phone (806) 355-3352

7400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 351-8480

Interoperability endpoints

  • Direct secure messaging: cbrooks21088@ahs.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1427231638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK DR",
            "address_2": "SUITE 2050",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062110",
            "telephone_number": "806-355-3352",
            "fax_number": "806-355-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK DR",
            "address_2": "SUITE 2050",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062110",
            "telephone_number": "806-355-3352",
            "fax_number": "806-355-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "CHARLES",
        "middle_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "M7874",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.092843",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2010-0147",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "35.092843",
            "identifier": "35.092843",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LIC# M7874",
            "identifier": "M7874",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO",
            "identifier": "MD2010-0147",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.