Individual provider Active NPI

Jeremy Seth Brook, D.C

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1962696872
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC27589 Issued in CA
Practice address
11686 Gateway Blvd
Los Angeles, CA 90064-2829
Phone
(310) 392-5456
Fax
(310) 444-5519
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC27589 CA Primary

Addresses

Primary practice location

11686 Gateway Blvd
Los Angeles, CA 90064-2829

Mailing address

11686 Gateway Blvd
Los Angeles, CA 90064-2829
Phone (310) 392-5456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071201000210 CA Practitioner - Chiropractic 0042309858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11686 Gateway Blvd
Los Angeles, CA 90064-2829
Phone (310) 392-5456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC27589CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Brook Chiropractic, Inc Chiropractor CurrentSince Dec 1, 2007 Accepting new patients

Locations

11686 Gateway Blvd
Los Angeles, CA 90064
Phone (310) 392-5456

11666 Gateway Blvd
Los Angeles, CA 90064
Phone (310) 392-5456

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1962696872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11686 GATEWAY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642829",
            "telephone_number": "310-392-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11686 GATEWAY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642829",
            "telephone_number": "310-392-5456",
            "fax_number": "310-444-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOK",
        "first_name": "JEREMY",
        "middle_name": "SETH",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC27589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.