Individual provider Active NPI

Stewart T Brooks, PA

  • Surgical Physician Assistant
  • Bryan, TX
National Provider Identifier
1639174170
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA06723 Issued in TX
Practice address
8441 State Highway 47 Ste 4300
Bryan, TX 77807-3235
Phone
(979) 776-8896
NPI assigned
Jun 20, 2005
Last updated
Aug 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA10004055 WA
Surgical Physician Assistant 363AS0400X PA06723 TX Primary

Addresses

Primary practice location

8441 State Highway 47 Ste 4300
Bryan, TX 77807-3235

Mailing address

8441 State Highway 47 Ste 4300
Bryan, TX 77807-3235
Phone (979) 776-8896

Other identifiers 1

IdentifierTypeStateIssuer
0211459OtherWAL&I NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100804000634 TX Practitioner - Physician Assistant 6507866936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph Regional Health CenterGroup PAC ID 5294727921, 141 clinicians

Practice addresses (Care Compare)

2801 Franciscan Dr
Bryan, TX 77802-2544
Phone (979) 776-2401

2803 Earl Rudder Fwy S
College Station, TX 77845-6099
Phone (979) 731-8888

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA06723TXMDSurgical Physician Assistant
PA10004055WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Regional Health Center CurrentSince Aug 1, 2013 Accepting new patients
St Joseph Regional Health Center CurrentSince Aug 1, 2013 Accepting new patients
College Station Hospital LP Past Accepting new patients
Jonathan a. Friedman, M.D., PLLC Past Accepting new patients
Clinical Neuroscience Services PLLC Past Accepting new patients
Neuromusculoskeletal Center of the Cascades PC Past Accepting new patients
St Joseph Physician Associates Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

Interoperability endpoints

  • Direct secure messaging: sbrooks455999@direct.stlukeshealth.org
  • Direct secure messaging: stewart.brooks@sjrhc.eclinicaldirectplus.com

Organizations & group practices 7

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 2

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1639174170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8441 STATE HIGHWAY 47 STE 4300",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778073235",
            "telephone_number": "979-776-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8441 STATE HIGHWAY 47 STE 4300",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778073235",
            "telephone_number": "979-776-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "STEWART",
        "middle_name": "T",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10004055",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA06723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER",
            "identifier": "0211459",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.