Individual provider Active NPI

Andre M Brooks, M.D

  • Cardiovascular Disease Physician
  • Weeki Wachee, FL
National Provider Identifier
1639244353
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
ME9444 Issued in FL
Practice address
10145 Cortez Blvd
Weeki Wachee, FL 34613-6385
Phone
(352) 597-4631
Fax
(352) 597-0076
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME9444 FL Primary

Addresses

Primary practice location

10145 Cortez Blvd
Weeki Wachee, FL 34613-6385

Mailing address

10091 Cortez Blvd
Weeki Wachee, FL 34613-6378
Phone (352) 597-4631

Other identifiers 1

IdentifierTypeStateIssuer
054647000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120206000267 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Family Practice 5395902225 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME9444FLMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart of Florida Cardiovascular Consultants PA CurrentSince Mar 30, 2023 Accepting new patients

Locations

5973 S Suncoast Blvd
Homosassa, FL 34446
Phone (352) 628-3212

5127 Commercial Way
Spring Hill, FL 34606
Phone (352) 597-4631

10091 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 592-7772

10145 Cortez Blvd
Weeki Wachee, FL 34613
Phone (352) 597-4631

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1639244353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10091 CORTEZ BLVD",
            "city": "WEEKI WACHEE",
            "state": "FL",
            "postal_code": "346136378",
            "telephone_number": "352-597-4631",
            "fax_number": "352-597-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10145 CORTEZ BLVD",
            "city": "WEEKI WACHEE",
            "state": "FL",
            "postal_code": "346136385",
            "telephone_number": "352-597-4631",
            "fax_number": "352-597-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "ANDRE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME9444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "054647000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weeki Wachee, FL

Sources for this page

Verify at the official NPI Registry.