Brooke E Bennis, D.O.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

20A14793 Issued in CA

Practice address

100 Shoreline Highway
210A
Mill Valley, CA 94941

Phone

(415) 388-5520

Fax

(415) 388-5503

NPI assigned

Apr 1, 2008

Last updated

Oct 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 28, 2018 through Jun 28, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1811169683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 BEARD RD",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583442",
            "telephone_number": "707-255-8825",
            "fax_number": "707-252-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SHORELINE HIGHWAY",
            "address_2": "210A",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "94941",
            "telephone_number": "415-388-5520",
            "fax_number": "415-388-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNIS",
        "first_name": "BROOKE",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "51271",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "DO170157",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "20A14793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erynn Anne Beeson, MD
• Robert E Belknap, MD
• Monica Beltrami, O.T.R
• Lauren Emily Bence, M.D.
• Benjaminrussack
• Tina Marie Benson, M.A.
• Claire Atterbury Bernard Miller, DPT
• Ann Bernhardt, PHD
• Eve Bernstein, D.C.
• Linden Farrar Berry, MFT (CA, 39,499)

• Physical Medicine & Rehabilitation Physician in Mill Valley, CA
• Providers in Mill Valley, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.