Individual provider Active NPI

Brian W Cook, MD

  • Emergency Medicine Physician
  • Clearwater, FL
National Provider Identifier
1790727642
Registry record updated Mar 11, 2011
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(2) exclusion effective Apr 20, 2014.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME0083573 Issued in FL
Practice address
2560 N McMullen Booth Rd
Ste B
Clearwater, FL 33761-4182
Phone
(727) 726-1962
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME0083573 FL Primary

Addresses

Primary practice location

2560 N McMullen Booth Rd
Ste B
Clearwater, FL 33761-4182

Mailing address

PO Box 17308
Clearwater, FL 33762-0308
Phone (904) 482-1070

Other identifiers 2

IdentifierTypeStateIssuer
06039OtherFLBLUE SHIELD OF FL
264873300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0083573FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Em-I Medical Services, PA Emergency Medicine Past Accepting new patients
Bay Area Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Palms of Pasadena Emergency Physicians LLC Emergency Medicine Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1790727642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17308",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337620308",
            "telephone_number": "904-482-1070",
            "fax_number": "904-482-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 N MCMULLEN BOOTH RD",
            "address_2": "STE B",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337614182",
            "telephone_number": "727-726-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "BRIAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0083573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF FL",
            "identifier": "06039",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264873300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.