NPIMap

Individual provider Active NPI

Jacob David Brooks, DO

  • Orthopaedic Surgery Physician
  • Bangor, ME
National Provider Identifier
1720244262
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
DO2333 Issued in ME
Practice address
78 Ridgewood Dr
Bangor, ME 04401-2652
Phone
(207) 307-8903
Fax
(207) 307-8913
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X DO2333 ME Primary

Addresses

Primary practice location

78 Ridgewood Dr
Bangor, ME 04401-2652

Mailing address

78 Ridgewood Dr
Bangor, ME 04401-2652
Phone (207) 307-8903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20130829000575 ME Practitioner - Orthopedic Surgery 3375786965 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Down East Orthopedic Assoc PA 14 clinicians
MRH Corp 36 clinicians

Practice addresses (Care Compare)

78 Ridgewood Dr
Bangor, ME 04401-2652
Phone (207) 947-8381

897 W Main St
Dover Foxcroft, ME 04426-1029
Phone (207) 564-8401

Hospital & facility affiliations

  • St Joseph Homecare Home health agency, Bangor, ME, CCN 207033
  • Community Health & Counseling Services Home health agency, Bangor, ME, CCN 207026
  • Amedisys Home Health Home health agency, Bangor, ME, CCN 207075
  • Northern Light Home Care & Hospice Home health agency, So Portland, ME, CCN 207020
  • Centerwell Home Health Home health agency, Bangor, ME, CCN 207045
  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001
  • Northern Light Mayo Hospital Hospital, Dover Foxcroft, ME, CCN 201309
  • Northern Light Eastern Maine Medical Center Hospital, Bangor, ME, CCN 200033
  • Cary Medical Center Hospital, Caribou, ME, CCN 200031
  • Penobscot Valley Hospital Hospital, Lincoln, ME, CCN 201303

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.4
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
82.24 of 100Reported as individual
Quality
65.76
Promoting interoperability
92
Improvement activities
40
Cost
76.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement28
Knee replacement47
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Down East Orthopedic Assoc PA Orthopaedic Surgery CurrentSince Jul 10, 2013 Accepting new patients
MRH Corp. CurrentSince Mar 1, 2020 Accepting new patients
St. Joseph Hospital Past Accepting new patients
MRH Corp. Past Accepting new patients

Locations

78 Ridgewood Dr
Bangor, ME 04401
Phone (207) 947-0768

360 Broadway
Bangor, ME 04401
Phone (207) 262-1703

891 W Main St
Ste 200
Dovr Foxcroft, ME 04426
Phone (207) 564-4464

43 Dwelley Ave
Dovr Foxcroft, ME 04426
Phone (207) 564-4450

891 W Main St
Ste 500
Dovr Foxcroft, ME 04426
Phone (207) 564-4466

897 W Main St
Dovr Foxcroft, ME 04426
Phone (207) 564-4464

Interoperability endpoints

  • Direct secure messaging: jacob.brooks.1@24925.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 10

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": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1720244262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-307-8903",
            "fax_number": "207-307-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 RIDGEWOOD DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012652",
            "telephone_number": "207-307-8903",
            "fax_number": "207-307-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "JACOB",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ME",
            "license": "DO2333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.