MRS. ANDREA RAE BROCKMAN MMS, PA-C
NPI 1043519929
Physician Assistant - Medical in Wellington, FL

Q: What is Andrea Brockman's NPI number?

The NPI number for Andrea Brockman is 1043519929. It was assigned to this individual provider in the NPPES registry on March 18, 2011.

Q: What is Andrea Brockman's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Andrea Brockman was last updated on December 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 18, 2011PECOS Enrolled

1397 MEDICAL PARK BLVD STE 220, WELLINGTON, FL 33414(561) 784-0202 Get Directions Write a Review

NPPES record last updated: December 15, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mrs. Andrea Rae Brockman Mms, Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ANDREA RAE BROCKMAN MMS, PA-C (NPI 1043519929) is an individual medical provider in Wellington, Florida, licensed in Florida (PA9105703) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043519929

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMRS. ANDREA RAE BROCKMANCredential: MMS, PA-C

Location Address1397 MEDICAL PARK BLVD STE 220Wellington, FL 33414-3187

Mailing Address1397 Medical Park Blvd Ste 220Wellington, FL 33414-3187

Phone(561) 784-0202

Sole ProprietorNo

Enumeration DateMarch 18, 2011

Last NPPES UpdateDecember 15, 2021

NPPES CertifiedDecember 15, 2021

✔ NPI 1043519929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in FL · PA9105703

1397 MEDICAL PARK BLVD STE 220, Wellington, FL 33414

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Andrea Rae Brockman Mms, Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier11 claims11 services$185.12 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEBRALYN M MCCLARNON

Nurse Practitioner (Family)