NPI Details
John M Brockenbrough, MD is an otolaryngology in Kirkland, WA with 29 years of experience. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. John M Brockenbrough, MD NPI is 1134154131. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
Education
Medical School: SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1997
The provider's business location address is:
12303 NE 130TH LN STE 400
KIRKLAND, WA
ZIP 98034-041
Phone: (425) 899-4590
Fax: (425) 899-4591
The NPI 1134154131 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.
- Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more (HCPCS:99213)
- New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more (HCPCS:99203)
- Diagnostic exam of voice box using a flexible endoscope (HCPCS:31575)
- New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more (HCPCS:99204)
- Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more (HCPCS:99214)
- Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more (HCPCS:99212)
- Melanoma (skin cancer) excision (HCPCS:)
The enumeration date for this NPI number is 7/11/2006 and was last updated on 12/12/2017.
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 |
| 1 | 207Y00000X | Otolaryngology | | 036101927 | ILLINOIS | 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 | 6447860011 | MEDICAID | ILLINOIS | |
