Individual provider Active NPI

Brooklyn Bach, NP

  • Acute Care Nurse Practitioner
  • Portland, OR
National Provider Identifier
1780077750
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
201800724NP-PP Issued in OR
Practice address
Ohsu Medicine Hematology & Medical Oncology
3181 SW Sam Jackson Park Rd; L586
Portland, OR 97239
Phone
(503) 494-8584
NPI assigned
Mar 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 687345 NY
Registered Nurse 163W00000X 2304378 MA
Acute Care Nurse Practitioner 363LA2100X 201800724NP-PP OR Primary

Addresses

Primary practice location

Ohsu Medicine Hematology & Medical Oncology
3181 SW Sam Jackson Park Rd; L586
Portland, OR 97239

Mailing address

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-5058

Other practice location 1

27 Park St
Hyannis, MA 02601-5230
Phone (508) 771-1800

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200402003275 CA Practitioner - Nurse Practitioner 6901194000 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of California San FranciscoGroup PAC ID 4486567229, 1,780 clinicians
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians

Practice addresses (Care Compare)

2330 Post St
San Francisco, CA 94115-3465
Phone (415) 476-4029

3100 San Pablo Ave
Berkeley, CA 94702-2498
Phone (510) 985-5020

400 Parnassus Ave
San Francisco, CA 94143-2202

Hospital & facility affiliations

  • UCSF Medical Center Hospital, San Francisco, CA, CCN 050454

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95
Improvement activities
40
Cost
80.65

Merit-based Incentive Payment System (MIPS)

Final score
84.89 of 100Reported as group
Quality
81.13
Improvement activities
40
Cost
71.5

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2304378MAMDRegistered Nurse
687345NYMDRegistered Nurse
201800724NP-PPORMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of the Monterey Peninsula CurrentSince Feb 1, 2022 Accepting new patients
UCSF Medical Group Business Services CurrentSince Feb 27, 2020 Accepting new patients
UCSF Medical Group Business Services Acute Care CurrentSince Feb 27, 2020 Accepting new patients
Community Hospital of the Monterey Peninsula CurrentSince Feb 1, 2022 Accepting new patients
UCSF Dept of Surgery CurrentSince Jul 27, 2020 Accepting new patients
University of California San Francisco Current Accepting new patients
University of California San Francisco CurrentSince Feb 27, 2020 Accepting new patients
University of California San Francisco CurrentSince Feb 27, 2020 Accepting new patients
Regents of the University of California CurrentSince Feb 27, 2020 Accepting new patients
Regents of the University of California Past Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

23625 Wr Holman Hwy
Monterey, CA 93940
Phone (831) 622-2708

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

1701 Divisadero St
Ste 120
San Francisco, CA 94115
Phone (415) 353-7655

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

Organizations & group practices 11

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": "1426291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1780077750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-5058",
            "fax_number": "503-494-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OHSU MEDICINE HEMATOLOGY & MEDICAL ONCOLOGY",
            "address_2": "3181 SW SAM JACKSON PARK RD; L586",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97239",
            "telephone_number": "503-494-8584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 Park St",
            "address_purpose": "LOCATION",
            "city": "Hyannis",
            "state": "MA",
            "postal_code": "026015230",
            "country_code": "US",
            "telephone_number": "508-771-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACH",
        "first_name": "BROOKLYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-14",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "687345",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "2304378",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201800724NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.