Active NPI
Brooke Menzie, PA-C
- Physician Assistant
- Mesa, AZ
National Provider Identifier
1902116460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4760
- Practice address
- 2152 S Vineyard
Suite 131
Mesa, AZ 85210-6871 - Phone
- (480) 820-2533
- NPI assigned
- Oct 18, 2010
- Last updated
- Nov 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 7798445-1206 | UT | |
| Physician Assistant | 363A00000X | 4760 | AZ | Primary |
Addresses
Primary practice location
2152 S Vineyard
Suite 131
Mesa, AZ 85210-6871
Mailing address
1863 S Recker Rd
Mesa, AZ 85206-4205
Phone (480) 270-4376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4760 | AZ | MD | Dentist |
| 7798445-1206 | UT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Texas Two Medical Group, PLLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Emergency Medicine Physician
- Mesa, AZ
- NPI 1912053752
-
- Emergency Medicine Physician
- San Antonio, TX
- NPI 1245938729
-
- Primary Care Clinic/Center
- Houston, TX
- NPI 1659950475
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321401600000",
"number": "1902116460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1863 S RECKER RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852064205",
"telephone_number": "480-270-4376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2152 S VINEYARD",
"address_2": "SUITE 131",
"city": "MESA",
"state": "AZ",
"postal_code": "852106871",
"telephone_number": "480-820-2533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENZIE",
"first_name": "BROOKE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-18",
"last_updated": "2011-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "7798445-1206",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "4760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.