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BROOKE BOETTLER
NPI 1205640539
Nurse Practitioner - Pediatrics in Oklahoma City, OK

Active since February 06, 2025PECOS Enrolled
1200 CHILDRENS AVE, OKLAHOMA CITY, OK 73104(405) 271-4357 Get Directions Write a Review

NPPES record last updated: February 6, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Brooke Boettler NPPES

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

BROOKE BOETTLER (NPI 1205640539) is an individual pediatrics provider in Oklahoma City, Oklahoma, licensed in Oklahoma (221938) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1205640539
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameBROOKE BOETTLER
Location Address1200 CHILDRENS AVEOklahoma City, OK 73104-4637
Mailing Address12641 Heritage Oaks DrOklahoma City, OK 73120-2092
Phone(405) 271-4357
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateFebruary 6, 2025
NPPES CertifiedFebruary 4, 2025
✔ NPI 1205640539 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in OK · 221938
1200 CHILDRENS AVE, Oklahoma City, OK 73104
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, Mending Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brooke Boettler is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9830695170
PECOS Enrollment IDI20251003004009
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.

Medicare Billing Reassignment

Medicare enrollment records show Brooke Boettler reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ou Health Partners, Inc
Same address
Multi-Specialty
1200 CHILDRENS AVE STE 11200
Oklahoma City, OK 73104
  • Reassigned Medicare billing, Oklahoma enrollment
  • 1,795 clinicians in this Medicare group
NPI 1528642642 (405) 271-3932

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

KRUTI SHAH
Student in an Organized Health Care Education/Training Program
1200 CHILDRENS AVE, SUITE 4D
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-8001
MRS. RACHEL LEIGH CROSS APRN, CPNP-PC
Nurse Practitioner (Pediatrics)
1200 CHILDRENS AVE, SUITE 10000
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4412
KAYLEE MARTIN
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-5437
KRISTEN PUENTE RD, LD
Dietitian, Registered
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4700
ROA MUQBEL
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4417
DR. CLAIRE ELIZABETH KUNKEL SMITH DO
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4417
JAY OGLE DO
Pediatrics
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4417
BLAYNE BORDWINE
Pediatrics (Hospice and Palliative Medicine)
1200 CHILDRENS AVE
OKLAHOMA CITY, OK 73104
Oklahoma County (405) 271-4700

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 Brooke Boettler's NPI number?

The NPI number for Brooke Boettler is 1205640539. It was assigned to this individual provider in the NPPES registry on February 6, 2025.

Where is Brooke Boettler located?

Brooke Boettler practices at 1200 Childrens Ave, Oklahoma City, OK 73104. The listed phone number is (405) 271-4357.

What is Brooke Boettler's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Brooke Boettler enrolled in Medicare?

Yes. Brooke Boettler is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Brooke Boettler's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brooke Boettler reassigns Medicare benefits to Ou Health Partners, Inc (Oklahoma City, OK). 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 Brooke Boettler's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brooke Boettler accept?

Health plans from Blue Cross and Blue Shield of Oklahoma and Mending Health list Brooke Boettler as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brooke Boettler was last updated on February 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.