Organization Active NPI

Brooks Management Inc

  • Clinical Medical Laboratory
  • Bradenton, FL
National Provider Identifier
1699031880
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
ME44267 Issued in FL
Legal business name
BROOKS MANAGEMENT INC
Practice address
2919 26TH St W
Bradenton, FL 34205-3737
Phone
(941) 755-2255
Fax
(941) 756-4465
NPI assigned
Apr 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Authorized official

Name
Dr. Jack C Jawitz, M.D.NPI 1316934714
Title
President
Phone
(941) 755-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X ME44267 FL Primary

Addresses

Primary practice location

2919 26TH St W
Bradenton, FL 34205-3737

Mailing address

2919 26TH St W
Bradenton, FL 34205-3737
Phone (941) 755-2255

Other identifiers 1

IdentifierTypeStateIssuer
068779100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120416000091 FL Part B Supplier - Clinic/Group Practice 2668633827 Receives reassigned benefits from 8 practitioners
Practice locations: Bradenton, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1699031880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342053737",
            "telephone_number": "941-755-2255",
            "fax_number": "941-756-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342053737",
            "telephone_number": "941-755-2255",
            "fax_number": "941-756-4465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKS MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "JAWITZ",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-755-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "ME44267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068779100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.