Individual provider Active NPI

Elizabeth Brooks, DPM

  • Podiatrist
  • Philadelphia, PA
National Provider Identifier
1487828133
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC003827L Issued in PA
Practice address
1546 Packer Ave
Philadelphia, PA 19145-5407
Phone
(215) 334-9900
Fax
(215) 467-9060
NPI assigned
Apr 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC003827L PA Primary

Addresses

Primary practice location

1546 Packer Ave
Philadelphia, PA 19145-5407

Mailing address

1546 Packer Ave
Philadelphia, PA 19145-5407
Phone (215) 334-9900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081114000767 PA Practitioner - Podiatry 3779643119 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Podiatric Medical and Surgical Associates, PC Podiatrist CurrentSince Oct 20, 2008 Accepting new patients

Locations

1546 Packer Ave
Philadelphia, PA 19145
Phone (215) 334-9900

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": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1487828133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1546 PACKER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191455407",
            "telephone_number": "215-334-9900",
            "fax_number": "215-467-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1546 PACKER AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191455407",
            "telephone_number": "215-334-9900",
            "fax_number": "215-467-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC003827L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.