NPIMap

Individual provider Active NPI

David Michael Brooker, DO

  • Internal Medicine Physician
  • Clarion, PA
National Provider Identifier
1689133787
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS023941 Issued in PA
Practice address
22631 Route 68 Ste 450B
Clarion, PA 16214-4076
Phone
(814) 227-2940
Fax
(814) 678-3377
NPI assigned
Mar 18, 2019
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X OS023941 PA Primary

Addresses

Primary practice location

22631 Route 68 Ste 450B
Clarion, PA 16214-4076

Mailing address

148 Maryal Dr
Pittsburgh, PA 15236-1950

Other practice location 1

320 E North Ave
Pittsburgh, PA 15212-4756
Phone (412) 359-3319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729002601 PA Practitioner - Internal Medicine 9931439536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coordinated Kidney Care Group IncGroup PAC ID 0345338281, 8 clinicians

Practice addresses (Care Compare)

22631 Route 68
Suite 450B
Clarion, PA 16214-4076
Phone (814) 227-2940

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS023941PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coordinated Kidney Care Group, Inc. CurrentSince Sep 3, 2024 Accepting new patients

Locations

6945 US 322
Unit 508
Cranberry, PA 16319
Phone (814) 678-1177

218 Oak St
Unit 2
Grove City, PA 16127
Phone (724) 264-4700

1 Nolte Dr
Bldg 700
Kittanning, PA 16201
Phone (412) 489-1980

Interoperability endpoints

  • Direct secure messaging: davidb@ntn.medentdirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1689133787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 MARYAL DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152361950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22631 ROUTE 68 STE 450B",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162144076",
            "telephone_number": "814-227-2940",
            "fax_number": "814-678-3377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 E North Ave",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152124756",
            "country_code": "US",
            "telephone_number": "412-359-3319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKER",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS023941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarion, PA

Sources for this page

Verify at the official NPI Registry.