NPIMap

Individual provider Active NPI

Brooke Pearce Cromer, PA-C

  • Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1558835223
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2979 Issued in OK
Practice address
5401 N Portland Ave Ste 600
Oklahoma City, OK 73112-2090
Phone
(405) 713-9940
Fax
(405) 713-9941
NPI assigned
Jan 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2979 OK Primary

Addresses

Primary practice location

5401 N Portland Ave Ste 600
Oklahoma City, OK 73112-2090

Mailing address

3001 Quail Springs Pkwy FL 5
Oklahoma City, OK 73134-2640
Phone (405) 713-9940

Other names 1

  • Brooke Siebenman Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190320001382 OK Practitioner - Physician Assistant 9830439348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians

Practice addresses (Care Compare)

3400 NW Expressway
Suite 500
Oklahoma City, OK 73112-4492
Phone (405) 945-4589

4401 S Western
Wound Care Clinic
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

4421 S Western Ave
Suite 1030
Oklahoma City, OK 73109-3413
Phone (405) 644-5398

5401 N Portland Ave
Suite 600
Oklahoma City, OK 73112-2121
Phone (405) 713-9940

5501 N Portland
Select Specialty Hosp West
Oklahoma City, OK 73112-2074
Phone (405) 951-4016

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.53 of 100Reported as apm
Quality
81.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2979OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care C Orporation Past Accepting new patients
Norman Regional Hospital Authority Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: bsiebenman147849@direct.integrisok.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1558835223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 QUAIL SPRINGS PKWY FL 5",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731342640",
            "telephone_number": "405-713-9940",
            "fax_number": "405-713-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N PORTLAND AVE STE 600",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122090",
            "telephone_number": "405-713-9940",
            "fax_number": "405-713-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROMER",
        "first_name": "BROOKE",
        "middle_name": "PEARCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "SIEBENMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.