Brooke Anne Stark, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

171773 Issued in NY

Practice address

5 Clay St
Malone, NY 12953-1905

Phone

(518) 483-0705

NPI assigned

Feb 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Regis Mohawk TribeGroup PAC ID 5799748547, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Vermont Health Network-Alice Hy Hospital, Malone, NY, CCN 331321

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• St Regis Mohawk Tribe

  • Federally Qualified Health Center (FQHC)
  • Akwesasne, NY
  • NPI 1457344558
  Medicare reassignment Care Compare group NPD
• Alice Hyde Medical Center

  • Critical Access Hospital
  • Malone, NY
  • NPI 1114954682
  Medicare reassignment NPD
• Alice Hyde Medical Center

  • Skilled Nursing Facility
  • Malone, NY
  • NPI 1356441349
  NPD (past)

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

• Alice Hyde Medical Center

  • Critical Access Hospital
  • Malone, NY
  • NPI 1114954682
  Care Compare affiliation

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1992459028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SCOTT DR",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129532407",
            "telephone_number": "518-260-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CLAY ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531905",
            "telephone_number": "518-483-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "BROOKE",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "171773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arielle Nicole Spaulding, RN
• Kevin Spaulding
• Kelly Spinner, RN
• Kimberly A Spinner, LPN
• Jason E Staley, RPH
• State of New York Office of State Comptroller
• Chris Ann Steele, APRN-CNP
• Mary Jo Sthilaire, R.PH.
• Patrick A Stjohn
• Danni-Ann Harriet Stmary, LPN/RN

• Family Medicine Physician in Malone, NY
• Providers in Malone, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.