Individual provider Active NPI

Brooke E Graziano, CRNP

  • Gerontology Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1740935188
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP024772 Issued in PA
Practice address
1250 S Cedar Crest Blvd Ste 300
Allentown, PA 18103-6381
Phone
(610) 402-3110
Fax
(610) 402-3112
NPI assigned
Feb 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP024772 PA Primary

Addresses

Primary practice location

1250 S Cedar Crest Blvd Ste 300
Allentown, PA 18103-6381

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 629-2282

Other identifiers 1

IdentifierTypeStateIssuer
SP024772OtherPASTATE LICENSE

Other names 1

  • Brooke E Medina Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220222000367 PA Practitioner - Nurse Practitioner 2860886694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1250 S Cedar Crest Blvd
300 LVPG Cardiology
Allentown, PA 18103-6381
Phone (610) 402-3110

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP024772PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Mar 21, 2022 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Mar 21, 2022 Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

3900 Hamilton Blvd
Ste 201
Allentown, PA 18103
Phone (484) 664-7520

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1250 S Cedar Crest Blvd
Ste 300
Allentown, PA 18103
Phone (610) 402-8275

2649 Schoenersville Rd
Ste 301
Bethlehem, PA 18017
Phone (484) 884-4799

5683 Route 115
Blakeslee, PA 18610
Phone (570) 355-7100

4807 Freemansburg Ave
Ste 250
Easton, PA 18045
Phone (484) 591-7630

14351 Kutztown Rd
Fleetwood, PA 19522
Phone (610) 944-8800

5649 Wynnewood Dr
Ste 203
Laurys Station, PA 18059
Phone (610) 261-1123

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

237 S Mountain Blvd
Ste 7
Mountain Top, PA 18707
Phone (570) 261-5000

1337 Blue Valley Dr
Ste 7
Pen Argyl, PA 18072
Phone (610) 654-1270

106 S Claude a Lord Blvd
Pottsville, PA 17901
Phone (570) 622-4209

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

Interoperability endpoints

  • Direct secure messaging: bmedina39891@direct2.lvhn.org

Organizations & group practices 5

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 5

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": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1740935188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-629-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CEDAR CREST BLVD STE 300",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036381",
            "telephone_number": "610-402-3110",
            "fax_number": "610-402-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAZIANO",
        "first_name": "BROOKE",
        "middle_name": "E",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP024772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SP024772",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "MEDINA",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.