Individual provider Active NPI

Donald F. Brooks, M.D.

  • Cardiovascular Disease Physician
  • Watervliet, MI
National Provider Identifier
1790733293
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301060799 Issued in MI
Practice address
450 Medical Park Dr
Suite # 400
Watervliet, MI 49098-8531
Phone
(269) 463-3044
Fax
(269) 463-8170
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301067099 MI
Cardiovascular Disease Physician 207RC0000X 4301060799 MI Primary

Addresses

Primary practice location

450 Medical Park Dr
Suite # 400
Watervliet, MI 49098-8531

Mailing address

450 Medical Park Dr
Suite # 400
Watervliet, MI 49098-8531
Phone (269) 463-3044

Other practice location 1

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 428-5007

Other practice location 2

400 Medical Park Dr
Watervliet, MI 49098-9225
Phone (269) 463-3044

Other identifiers 1

IdentifierTypeStateIssuer
103069741MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041214000427 MI Practitioner - Cardiovascular Disease (Cardiology) 7214994052 Reassigns benefits to 2 organizations
Practice locations: Coloma, MI; Kalamazoo, MI; Watervliet, MI

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301067099MIMDSpecialist
4301060799MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet CurrentSince Jul 1, 2010 Accepting new patients
Lakeland Medical Practices CurrentSince Feb 6, 2019 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Jul 1, 2010 Accepting new patients
Lakeland Medical Practices CurrentSince Feb 6, 2019 Accepting new patients
Lakeland Community Hospital Watervliet Current Accepting new patients
Red Arrow Medical Clinic PC PastSince Jan 24, 2015 Accepting new patients

Locations

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

450 Medical Park Dr
Ste 200
Watervliet, MI 49098
Phone (269) 463-3733

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

Interoperability endpoints

  • Direct secure messaging: dbrooks1268687@epic00.corewelldirect.org
  • Direct secure messaging: dbrooks7574@lakeland.midirect.net
  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/

Organizations & group practices 6

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1790733293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MEDICAL PARK DR",
            "address_2": "SUITE # 400",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490988531",
            "telephone_number": "269-463-3044",
            "fax_number": "269-463-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MEDICAL PARK DR",
            "address_2": "SUITE # 400",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490988531",
            "telephone_number": "269-463-3044",
            "fax_number": "269-463-8170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1234 Napier Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MI",
            "postal_code": "490852112",
            "country_code": "US",
            "telephone_number": "269-428-5007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Watervliet",
            "state": "MI",
            "postal_code": "490989225",
            "country_code": "US",
            "telephone_number": "269-463-3044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "DONALD",
        "middle_name": "F.",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301067099",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301060799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103069741",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watervliet, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.