BROOKTIETE ASSERES M.D. NPI 1063732055

NPI Information

NPI: 1063732055
Provider Name: BROOKTIETE ASSERES, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3569 WILLOW GREEN DR
APEX, NC
ZIP 27502
Phone: (240) 338-1418
Get Directions

Brooktiete Asseres, M.D. is a pediatrics in Apex, NC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Brooktiete Asseres, M.D. NPI is 1063732055. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3569 WILLOW GREEN DR
APEX, NC
ZIP 27502-507
Phone: (240) 338-1418

The NPI 1063732055 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/2/2010 and was last updated on 11/22/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	208000000X	Pediatrics	D97797	MARYLAND	No
2	208D00000X	General Practice	2013-01617	NORTH CAROLINA	No
3	208000000X	Pediatrics	2013-01617	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1063732055	OTHER	NORTH CAROLINA	HEALTHSMART
2	13305729	OTHER	NORTH CAROLINA	PHCS-MULTIPLAN
3	1513788	OTHER	NORTH CAROLINA	COVENTRY OF THE CAROLINAS
4	9225005	OTHER	NORTH CAROLINA	CIGNA-GREATWEST
5	1063732055	OTHER	NORTH CAROLINA	HEALTHNET FEDERAL SERVICES
6	FH1101395	OTHER	NORTH CAROLINA	FIRST CAROLINA CARE
7	1063732055	MEDICAID	NORTH CAROLINA
8	3652537	OTHER	NORTH CAROLINA	UNITED HEALTHCARE
9	1063732055	OTHER	NORTH CAROLINA	HUMANA
10	1806P	OTHER	NORTH CAROLINA	BCBS OF NC
11	7520999	OTHER	NORTH CAROLINA	AETNA
12	1063732055	OTHER	NORTH CAROLINA	DOCTORS DIRECT
13	1513788	OTHER	NORTH CAROLINA	WELLPATH
14	247602	OTHER	NORTH CAROLINA	MEDCOST, LLC
15	4468100	OTHER	NORTH CAROLINA	COVENTRY NATIONAL - COVENTRY PPO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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