Brian Scott Brooks, PA
Individual provider Active NPI Physician Assistant · Hawthorne, FL
NPI 1962401554 · NPPES record last updated Feb 25, 2020
Key facts
- NPI
- 1962401554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA3061 (FL)
- Practice address
- 22066 SE 71St Ave
Hawthorne, FL 32640-3969 - Phone
- (352) 481-2700
- Fax
- (352) 481-2392
- NPI assigned
- Jul 18, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1995
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Rural Health Care Incorporated
Lake Area Physical Therapy Inc.
Practice addresses (Care Compare)
1302 River St
Palatka, FL 32177-5042
Phone (386) 328-8371
22066 SE 71St Ave
Hawthorne, FL 32640-3969
Phone (352) 481-2700
PO Box
Suite 1099
Melrose, FL 32666-1099
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080104000448 | FL | Practitioner - Physician Assistant | 6800976721 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA3061 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rural Health Care, Incorporated | Current |
Accepting new patients | |
| Rural Health Care, Inc. | Current |
Accepting new patients | |
| Atlas Diagnostics Inc | Past | Accepting new patients | |
| Rural Health Care Incorporated | Past | Accepting new patients |
Locations
22018 SE 71st Ave
Hawthorne, FL 32640
Phone (352) 481-2700
22066 SE 71st Ave
Hawthorne, FL 32640
Phone (352) 481-2700
100 Commercial Dr
Keystone Hgts, FL 32656
Phone (352) 473-6595
1302 River St
Palatka, FL 32177
Phone (386) 328-0108
Interoperability endpoints
- brianscott.brooks.p1@direct.azahealth.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA3061 | FL | Yes |
Addresses
Primary practice location
22066 SE 71St Ave
Hawthorne, FL 32640-3969
Mailing address
1302 River St
Palatka, FL 32177-5042
Phone (386) 326-7342
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 290204400 | Medicaid | FL |
Other providers in Hawthorne, FL
- Hailee Banks
- Brittany Baxley
- Best Care Transport Inc
- Bio Medical Applications of Florida, Inc
- Michelle Blackwood
- Celtic Enterprize Inc
- Celtic Enterprize Inc
- Tynnatta Chess
- Joseph J Ciccio
- Richard Lee Colonel
All providers in Hawthorne, FL · Physician Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.