Individual provider Active NPI

Rachel Ellen Brooks, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Portland, OR
National Provider Identifier
1669573747
Registry record updated Oct 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
18107 Issued in OR
Practice address
3440 SE Harold CT
Portland, OR 97202-4342
Phone
(503) 232-4780
Fax
(503) 265-5002
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 18107 OR Primary

Addresses

Primary practice location

3440 SE Harold CT
Portland, OR 97202-4342

Mailing address

3440 SE Harold CT
Portland, OR 97202-4342
Phone (503) 232-4780

Other identifiers 1

IdentifierTypeStateIssuer
18107OtherORMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20101229001142 OR Practitioner - Physical Medicine and Rehabilitation 9830387240 Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Michigan Medical School, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3440 SE Harold CT
Portland, OR 97202-4342
Phone (503) 232-4780

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18107ORMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603497600000",
    "number": "1669573747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 SE HAROLD CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972024342",
            "telephone_number": "503-232-4780",
            "fax_number": "503-265-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 SE HAROLD CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972024342",
            "telephone_number": "503-232-4780",
            "fax_number": "503-265-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "RACHEL",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-10-24",
        "certification_date": "2020-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "18107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "18107",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.