Individual provider Active NPI

Kylie Brookes, M.D.

  • Hospitalist Physician
  • Berkeley, CA
National Provider Identifier
1982887006
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
C145300 Issued in CA
Practice address
2450 Ashby Ave Ste 3040
Berkeley, CA 94705-2067
Phone
(510) 204-3977
Fax
(510) 204-5429
NPI assigned
Dec 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 145300 CA
Hospitalist Physician 208M00000X C145300 CA Primary

Addresses

Primary practice location

2450 Ashby Ave Ste 3040
Berkeley, CA 94705-2067

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (510) 204-3977

Other practice location 1

2180 Main St
Wailuku, HI 96793-1625
Phone (808) 242-6464

Other identifiers 1

IdentifierTypeStateIssuer
C145300OtherCASTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C145300CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Raphael Healthcare System Affiliated Physicians Inc Obstetrics & Gynecology Past Accepting new patients
Saint Raphael Faculty Physicians Obstetrics & Gynecology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kbrookes365174@hisp.ehr.sutterhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1982887006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "510-204-3977",
            "fax_number": "510-204-5429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 ASHBY AVE STE 3040",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052067",
            "telephone_number": "510-204-3977",
            "fax_number": "510-204-5429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2180 Main St",
            "address_purpose": "LOCATION",
            "city": "Wailuku",
            "state": "HI",
            "postal_code": "967931625",
            "country_code": "US",
            "telephone_number": "808-242-6464",
            "fax_number": "808-242-4267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROOKES",
        "first_name": "KYLIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-12",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "145300",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "C145300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "C145300",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.