Individual provider Active NPI

Brooke M Dix, DPM

  • Foot & Ankle Surgery Podiatrist
  • Mountain View, CA
National Provider Identifier
1790030393
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5088 Issued in CA
Practice address
305 South Dr
6
Mountain View, CA 94040-4200
Phone
(650) 215-8722
Fax
(650) 964-0720
NPI assigned
Jul 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E5088 CA
Primary Podiatric Medicine Podiatrist 213EP1101X E5088 CA
Public Medicine Podiatrist 213EP0504X E5088 CA
Sports Medicine Podiatrist 213ES0000X E5088 CA
Radiology Podiatrist 213ER0200X E5088 CA
Foot Surgery Podiatrist 213ES0131X E5088 CA
Foot & Ankle Surgery Podiatrist 213ES0103X E5088 CA Primary

Addresses

Primary practice location

305 South Dr
6
Mountain View, CA 94040-4200

Mailing address

305 South Dr
6
Mountain View, CA 94040-4200
Phone (650) 215-8722

Other identifiers 1

IdentifierTypeStateIssuer
E-5088OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140103000099 CA Practitioner - Podiatry 9335377019 Practice locations: Stockton, CA; Sunnyvale, CA
I20200306001013 CA Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 9335377019 Practice locations: Mountain View, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

500 E Remington Dr
Suite 29
Sunnyvale, CA 94087-2612
Phone (650) 215-8722

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue34
Removal or shaving of skin growth33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5088CAMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1790030393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SOUTH DR",
            "address_2": "6",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404200",
            "telephone_number": "650-215-8722",
            "fax_number": "650-964-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SOUTH DR",
            "address_2": "6",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404200",
            "telephone_number": "650-215-8722",
            "fax_number": "650-964-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIX",
        "first_name": "BROOKE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5088",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "CA",
            "license": "E5088",
            "primary": false
        },
        {
            "code": "213EP0504X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Public Medicine",
            "state": "CA",
            "license": "E5088",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "CA",
            "license": "E5088",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "CA",
            "license": "E5088",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CA",
            "license": "E5088",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "E-5088",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.