Active NPI
Jason Clifford Brookman, M.D.
- Anesthesiology Physician
- Baltimore, MD
National Provider Identifier
1881886166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- D72455
- Practice address
- 600 N Wolfe St Nelson 2 133
Baltimore, MD 21287-0010 - Phone
- (410) 955-5608
- NPI assigned
- Aug 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 221786 | MA | |
| Anesthesiology Physician | 207L00000X | MD439683 | PA | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | MD439683 | PA | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | D72455 | MD | |
| Anesthesiology Physician | 207L00000X | D72455 | MD | Primary |
Addresses
Primary practice location
600 N Wolfe St Nelson 2 133
Baltimore, MD 21287-0010
Mailing address
PO Box 64382
Baltimore, MD 21264-4382
Phone (410) 955-5608
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046649200 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110812000368 | MD | Practitioner - Anesthesiology | 0042406811 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shock Trauma Associates PA
Practice addresses (Care Compare)
22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-6704
Hospital & facility affiliations
- University of Maryland Medical Center
- University of MD Medical Center Midtown Campus
- University of MD Shore Medical Center at Easton
- Frederick Health Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 221786 | MA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shock Trauma Associates, P.a. | Current | Accepting new patients | |
| North American Partners in Anesthesia Maryland LLC | Anesthesiology | Current | Accepting new patients |
Locations
2401 W Belvedere Ave
Baltimore, MD 21215
22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793
5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727
Interoperability endpoints
- jbrookman641675@direct.umm.edu
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Prince Frederick, MD
- NPI 1093707879
Anesthesiology, MD
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Baltimore, MD
- NPI 1174660120
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588204800000",
"number": "1881886166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 64382",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212644382",
"telephone_number": "410-955-5608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N WOLFE ST NELSON 2 133",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212870010",
"telephone_number": "410-955-5608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKMAN",
"first_name": "JASON",
"middle_name": "CLIFFORD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-10",
"last_updated": "2020-04-30",
"certification_date": "2020-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MA",
"license": "221786",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "PA",
"license": "MD439683",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "PA",
"license": "MD439683",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "MD",
"license": "D72455",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MD",
"license": "D72455",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046649200",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.