Active NPI
Laura D Brake, PA-C
- Medical Physician Assistant
- Phoenixville, PA
National Provider Identifier
1679764633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- MA054467
- Practice address
- 140 Nutt Rd
Phoenixville, PA 19460-3906 - Phone
- (610) 983-1221
- NPI assigned
- Aug 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | MA054467 | PA | Primary |
| Physician Assistant | 363A00000X | OA002510 | PA |
Addresses
Primary practice location
140 Nutt Rd
Phoenixville, PA 19460-3906
Mailing address
PO Box 425
Lederach, PA 19450-0425
Phone (800) 528-0006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
110 Irving St NW
Washington, DC 20010-3017
Phone (202) 877-7000
29955 Three Notch Rd
100 MMG at Charlotte Hall
Charlotte Hall, MD 20622-3159
Phone (301) 290-5300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
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": "1186358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315526400000",
"number": "1679764633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 425",
"city": "LEDERACH",
"state": "PA",
"postal_code": "194500425",
"telephone_number": "800-528-0006",
"fax_number": "732-349-6030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 NUTT RD",
"city": "PHOENIXVILLE",
"state": "PA",
"postal_code": "194603906",
"telephone_number": "610-983-1221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAKE",
"first_name": "LAURA",
"middle_name": "D",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-06",
"last_updated": "2011-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PA",
"license": "MA054467",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "OA002510",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenixville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.