Individual provider Active NPI

John V Brooks, M.D.

  • Infectious Disease Physician
  • Port Huron, MI
National Provider Identifier
1598731473
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301056328 Issued in MI
Practice address
1231 Pine Grove Ave
Infectious Disease, Suite 1B
Port Huron, MI 48060-3500
Phone
(810) 966-1993
Fax
(810) 966-1997
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 4301056328 MI Primary

Addresses

Primary practice location

1231 Pine Grove Ave
Infectious Disease, Suite 1B
Port Huron, MI 48060-3500

Mailing address

15474 N Haggerty Rd
Plymouth, MI 48170-4893
Phone (734) 335-6103

Other identifiers 1

IdentifierTypeStateIssuer
1598731473MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100419000736 MI Practitioner - Infectious Disease 8628105962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Wayne State University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Port HuronGroup PAC ID 9931018702, 48 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Port Huron Current Accepting new patients
McLaren Port Huron CurrentSince May 15, 2020 Accepting new patients
Blue Water OB & GYN PC PastSince Aug 1, 1999 Accepting new patients

Locations

1216 Richardson St
Port Huron, MI 48060
Phone (810) 985-2640

1107 Stone St
Ste 3
Port Huron, MI 48060
Phone (810) 204-4494

1313 Stone St
Port Huron, MI 48060
Phone (810) 984-3181

1231 Pine Grove Ave
Ste 1B
Port Huron, MI 48060
Phone (810) 984-8650

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

1163 S Carney Dr
Saint Clair, MI 48079
Phone (810) 561-8450

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1598731473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15474 N HAGGERTY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704893",
            "telephone_number": "734-335-6103",
            "fax_number": "630-734-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 PINE GROVE AVE",
            "address_2": "INFECTIOUS DISEASE, SUITE 1B",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603500",
            "telephone_number": "810-966-1993",
            "fax_number": "810-966-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JOHN",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301056328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598731473",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.