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DR. KIMBERLY BROWN BROCKENBROUGH M.D. NPI 1205864204


NPI Information

NPI: 1205864204
Provider Name: DR. KIMBERLY BROWN BROCKENBROUGH, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
19020 33RD AVE W
SUITE 210
LYNNWOOD, WA
ZIP 98036
Phone: (425) 563-1500
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DR. Kimberly Brown Brockenbrough, M.D. is a diagnostic radiology radiology in Lynnwood, WA with 27 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Kimberly Brown Brockenbrough, M.D. NPI is 1205864204. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1997

The provider's business location address is:

19020 33RD AVE W
SUITE 210
LYNNWOOD, WA
ZIP 98036-746
Phone: (425) 563-1500
Fax: (425) 563-1374

The NPI 1205864204 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • X-ray of chest, 2 views (HCPCS:71046)
  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • X-ray of chest, 1 view (HCPCS:71045)
  • X-ray of shoulder, minimum of 2 views (HCPCS:73030)
  • Ct scan chest (HCPCS:71250)

The enumeration date for this NPI number is 6/29/2006 and was last updated on 2/4/2015.


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 Taxonomy Specialization License Number License State Primary
12085U0001XRadiologyDiagnostic Ultrasound036107196ILLINOISNo
22085R0202XRadiologyDiagnostic RadiologyMD60484894WASHINGTONYes

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
1H58750MEDICARE UPIN
2IL3270268MEDICARE PINILLINOIS
3G8931463MEDICARE PINWASHINGTON
4G8931465MEDICARE PINWASHINGTON
56447860011MEDICARE NSCILLINOIS
6G8931462MEDICARE PINWASHINGTON
7H58750MEDICARE UPINILLINOIS
82038328MEDICAIDWASHINGTON
9P01392944MEDICARE PINWASHINGTON
10G8931464MEDICARE PINWASHINGTON

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.