STEFANIE RAE BROCKER RD
NPI 1154002475
Nutritionist in Baltimore, MD
About Stefanie Rae Brocker Rd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STEFANIE RAE BROCKER RD (NPI 1154002475) is an individual nutritionist in Baltimore, Maryland, licensed in Maryland (DX4893) and active in the NPI registry since July 2023.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Stefanie Rae Brocker Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Stefanie Brocker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Baltimore, MD 21201
- Reassigned Medicare billing, Maryland enrollment
- 128 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BALTIMORE, MD 21201
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Stefanie Brocker's NPI number?
The NPI number for Stefanie Brocker is 1154002475. It was assigned to this individual provider in the NPPES registry on July 28, 2023.
Where is Stefanie Brocker located?
Stefanie Brocker practices at 800 Linden Ave Fl 8, Baltimore, MD 21201. The listed phone number is (443) 682-6800.
What is Stefanie Brocker's specialty?
The primary specialty registered for this NPI is Nutritionist with taxonomy code 133N00000X.
Is Stefanie Brocker enrolled in Medicare?
Yes. Stefanie Brocker is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Stefanie Brocker's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Stefanie Brocker reassigns Medicare benefits to Maryland General Clinical Practice Group, Inc. (Baltimore, MD). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stefanie Brocker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Stefanie Brocker was last updated on March 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.
# Stefanie Rae Brocker, RD · NPI 1154002475
Nutritionist provider in Baltimore, Maryland. Individual provider, active in the CMS NPPES registry since July 28, 2023.
## Identity
- **NPI:** 1154002475 (Entity type: Individual)
- **Enumerated:** July 28, 2023
- **Primary specialty:** Nutritionist · taxonomy 133N00000X
- **State license:** DX4893 (Maryland)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 800 LINDEN AVE FL 8, Baltimore, MD 21201-4622
- **Phone:** (443) 682-6800
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Maryland General Clinical Practice Group, Inc. (NPI 1689413197, Baltimore, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 25, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1154002475) · Data from the CMS NPPES public registry.