Andrew John Van Brocklin, DO

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

OS11531 Issued in FL

Practice address

8333 N Davis Hwy
Pensacola, FL 32514-6050

Phone

(850) 474-8015

Fax

(850) 969-2840

NPI assigned

Oct 14, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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.

Enrollment records 1

Specialty

Interventional Pain Management

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Florida Medical Center Clinic PAGroup PAC ID 7416860705, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida West Hospital Hospital, Pensacola, FL, CCN 100231

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrewvanbrocklin@medcenterclinic.direct.emds.com

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.

• West Florida Medical Center Clinic, PA

  • Multi-Specialty Clinic/Center
  • Pensacola, FL
  • NPI 1568452688
  Medicare reassignment Care Compare group NPD
• Pain Consultants of West Florida

  • Pain Clinic/Center
  • Pensacola, FL
  • NPI 1508445966
  NPD (past)
• West Florida Medical Center Clinic PA

  • Ambulatory Surgical Clinic/Center
  • Pensacola, FL
  • NPI 1043396245
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• West Florida Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1639116726
  Care Compare affiliation

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1902181555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146050",
            "telephone_number": "850-474-8100",
            "fax_number": "850-474-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325146050",
            "telephone_number": "850-474-8015",
            "fax_number": "850-969-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BROCKLIN",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-14",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "OS015794",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "OS11531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009795100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Valencia
• Felipe Andres Valencia, PA-C
• Barbara Lee Valletto, RN, SANE-A
• Jacqueline I Vallin, APRN
• Temisia Van Biljouw-Bath, M.D.
• Yira Van Der Linde, MD
• Kimberly Dawn Van Diepen
• Andrew Van Nispen, DO
• Joshua David Van Vleet, FNP-C
• Caitlin Jean Van Why, PA-C

• Pain Medicine (Anesthesiology) Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Pain Medicine (Anesthesiology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.

Verify at the official NPI Registry.