Individual provider Active NPI

Brooke Ashley Gifford, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Newbury Park, CA
National Provider Identifier
1750563995
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4889 Issued in CA
Practice address
3095 Old Conejo Rd Ste 100
Newbury Park, CA 91320-2130
Phone
(805) 273-1415
Fax
(805) 823-6207
NPI assigned
Nov 29, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E4889 CA Primary

Addresses

Primary practice location

3095 Old Conejo Rd Ste 100
Newbury Park, CA 91320-2130

Mailing address

3095 Old Conejo Rd Ste 100
Newbury Park, CA 91320-2130
Phone (805) 273-1415

Other identifiers 1

IdentifierTypeStateIssuer
E4889OtherCALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110118000086 CA Practitioner - Podiatry 9335338722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Performance Foot and Ankle IncGroup PAC ID 2466713896, 3 clinicians

Practice addresses (Care Compare)

3095 Old Conejo Rd
Suite 100
Newbury Park, CA 91320-2130
Phone (805) 273-1415

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76 of 100Reported as group
Quality
52
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue39
Removal of skin lesions1-10
Removal of nail tissue724
Removal or shaving of skin growth719
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4889CAMDPsychologist
E4889CAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Foot & Ankle Inc Foot & Ankle Surgery CurrentSince Mar 31, 2018 Accepting new patients
Brooke Gifford, DPM Inc Foot & Ankle Surgery CurrentSince Jun 19, 2012 Accepting new patients
Los Robles Regional Medical Center Past Accepting new patients

Locations

3095 Old Conejo Rd
Ste 100
Thousand Oaks, CA 91320
Phone (805) 273-1415

425 Haaland Dr
Ste 201
Thousand Oaks, CA 91361
Phone (805) 496-2383

Organizations & group practices 3

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": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1750563995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 OLD CONEJO RD STE 100",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913202130",
            "telephone_number": "805-273-1415",
            "fax_number": "805-823-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 OLD CONEJO RD STE 100",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913202130",
            "telephone_number": "805-273-1415",
            "fax_number": "805-823-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIFFORD",
        "first_name": "BROOKE",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "E4889",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newbury Park, CA

Sources for this page

Verify at the official NPI Registry.