Individual provider Active NPI

Brooke Elise Gambino, NP

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1619631587
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
273250 Issued in AZ
Practice address
4200 E Camelback Rd Ste 202
Phoenix, AZ 85018-2718
Phone
(602) 521-3090
NPI assigned
Oct 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 273250 AZ Primary
Critical Care Medicine Registered Nurse 163WC0200X RN193224 AZ

Addresses

Primary practice location

4200 E Camelback Rd Ste 202
Phoenix, AZ 85018-2718

Mailing address

4200 E Camelback Rd Ste 202
Phoenix, AZ 85018-2718
Phone (602) 521-3090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912000176 AZ Practitioner - Nurse Practitioner 8224413398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner - University Physician Specialists LLCGroup PAC ID 5991008054, 343 clinicians

Practice addresses (Care Compare)

4200 E Camelback Rd
Suite 202
Phoenix, AZ 85018-2718
Phone (602) 229-2200

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
273250AZMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Mar 10, 2025 Accepting new patients
Banner - University Physician Specialists LLC Current Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

755 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 271-5111

4200 E Camelback Rd
Ste 202
Phoenix, AZ 85018
Phone (602) 229-2150

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

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": "1635292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1619631587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 E CAMELBACK RD STE 202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182718",
            "telephone_number": "602-521-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 E CAMELBACK RD STE 202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182718",
            "telephone_number": "602-521-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBINO",
        "first_name": "BROOKE",
        "middle_name": "ELISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-27",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "273250",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "AZ",
            "license": "RN193224",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.