Individual provider Active NPI

Nichole V. Brooks, PA-C

  • Physician Assistant
  • Charlottesville, VA
National Provider Identifier
1740706803
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110008971 Issued in VA
Practice address
1300 Jefferson Park Ave
Charlottesville, VA 22903-3363
Phone
(434) 924-5078
Fax
(434) 924-8118
NPI assigned
Aug 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 021192 NY
Physician Assistant 363A00000X 0010-08005 NC
Physician Assistant 363A00000X 0110008971 VA Primary

Addresses

Primary practice location

1300 Jefferson Park Ave
Charlottesville, VA 22903-3363

Mailing address

PO Box 9007
Charlottesville, VA 22906-9007
Phone (434) 295-1000

Other practice location 1

1040 Park Ave Ste 1D-E
New York, NY 10028-1032
Phone (212) 744-4400

Other practice location 2

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-2697

Other practice location 3

1215 Lee St
Charlottesville, VA 22908-3363
Phone (434) 924-0211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221227001230 VA Practitioner - Physician Assistant 3375895147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Virginia Physicians GroupGroup PAC ID 4880590728, 1,685 clinicians

Practice addresses (Care Compare)

1215 Lee St
Charlottesville, VA 22908-0816

1300 Jefferson Park Ave
Charlottesville, VA 22903-3363

652 Peter Jefferson Pkwy
Suite 310
Charlottesville, VA 22911-8849
Phone (434) 924-5236

Hospital & facility affiliations

  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

Merit-based Incentive Payment System (MIPS)

Final score
86.45 of 100Reported as group
Quality
79.76
Promoting interoperability
100
Improvement activities
40
Cost
75.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince Jan 9, 2023 Accepting new patients

Locations

1300 Jefferson Park Ave
Charlottesville, VA 22903
Phone (434) 924-2241

650 Peter Jefferson Pkwy
Ste 200
Charlottesville, VA 22911

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

Interoperability endpoints

  • Direct secure messaging: nbrooks548971@direct.healthsystem.virginia.edu

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.

Hospital & facility affiliations 1

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": "1503187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1740706803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9007",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229069007",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 JEFFERSON PARK AVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229033363",
            "telephone_number": "434-924-5078",
            "fax_number": "434-924-8118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 Park Ave Ste 1D-E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100281032",
            "country_code": "US",
            "telephone_number": "212-744-4400",
            "fax_number": "212-535-4644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 Duke Medicine Cir",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "27710",
            "country_code": "US",
            "telephone_number": "919-681-2697",
            "fax_number": "919-681-2670",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229083363",
            "country_code": "US",
            "telephone_number": "434-924-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "NICHOLE",
        "middle_name": "V.",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-20",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021192",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08005",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.