BROCK EVAN BOOTH
NPI 1194287862
Student in an Organized Health Care Education/Training Program in Santa Ana, CA
About Brock Evan Booth NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BROCK EVAN BOOTH (NPI 1194287862) is an individual student in an organized health care education/training program in Santa Ana, California and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS and is a graduate of Des Moines University Of Osteopathic Medicine And Health Sciences (2019).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Brock Evan Booth is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SANTA ANA, CA 92705
SANTA ANA, CA 92705
SANTA ANA, CA 92705
SANTA ANA, CA 92705
SANTA ANA, CA 92705
SANTA ANA, CA 92705
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 Brock Booth's NPI number?
The NPI number for Brock Booth is 1194287862. It was assigned to this individual provider in the NPPES registry on April 2, 2019.
Where is Brock Booth located?
Brock Booth practices at 1900 E 4th St, Santa Ana, CA 92705. The listed phone number is (714) 967-4766.
What is Brock Booth's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Brock Booth enrolled in Medicare?
Yes. Brock Booth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
When was this NPI record last updated?
The NPPES record for Brock Booth was last updated on November 29, 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.
# Brock Evan Booth · NPI 1194287862
Student in an Organized Health Care Education/Training Program provider in Santa Ana, California. Individual provider, active in the CMS NPPES registry since April 2, 2019.
## Identity
- **NPI:** 1194287862 (Entity type: Individual)
- **Enumerated:** April 2, 2019
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1900 E 4TH ST, Santa Ana, CA 92705-3910
- **Phone:** (714) 967-4766
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Des Moines University Of Osteopathic Medicine And Health Sciences, class of 2019
## Record status
- **NPPES last updated:** November 29, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1194287862) · Data from the CMS NPPES public registry.