1. Home
  2. Directory
  3. Texas
  4. Dallas
  5. Nurse Practitioner
  6. NPI Profile

BREONNA CHANTE ROBERTS-COOK APRN, FNP-C
NPI 1205782117
Nurse Practitioner - Family in Dallas, TX

Active since March 05, 2026PECOS Enrolled
3436 S POLK ST STE A, DALLAS, TX 75224(214) 372-9200 Get Directions Write a Review

NPPES record last updated: March 5, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Breonna Chante Roberts-cook Aprn, Fnp-c NPPES

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

BREONNA CHANTE ROBERTS-COOK APRN, FNP-C (NPI 1205782117) is an individual family provider in Dallas, Texas, licensed in Texas (1228656) and active in the NPI registry since March 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1205782117
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameBREONNA CHANTE ROBERTS-COOKCredential: APRN, FNP-C
Location Address3436 S POLK ST STE ADallas, TX 75224-3804
Mailing Address5822 Goldeneye LnDallas, TX 75249-2305
Phone(214) 372-9200
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMarch 5, 2026
NPPES CertifiedMarch 5, 2026
✔ NPI 1205782117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TX · 1228656
3436 S POLK ST STE A, Dallas, TX 75224
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Breonna Chante Roberts-cook Aprn, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2365912078
PECOS Enrollment IDI20260522001927
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 Breonna Roberts-cook reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

South Polk Medical Clinic LLC
0.1 mi
Nurse Practitioner
3436 S POLK ST
Dallas, TX 75224
  • Reassigned Medicare billing, Texas enrollment
  • 4 clinicians in this Medicare group
NPI 1043351760 (214) 372-1051

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 75224 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
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.

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 Breonna Roberts-cook's NPI number?

The NPI number for Breonna Roberts-cook is 1205782117. It was assigned to this individual provider in the NPPES registry on March 5, 2026.

Where is Breonna Roberts-cook located?

Breonna Roberts-cook practices at 3436 S Polk St Ste A, Dallas, TX 75224. The listed phone number is (214) 372-9200.

What is Breonna Roberts-cook's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Breonna Roberts-cook enrolled in Medicare?

Yes. Breonna Roberts-cook is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Breonna Roberts-cook's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Breonna Roberts-cook reassigns Medicare benefits to South Polk Medical Clinic LLC (Dallas, TX). 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 Breonna Roberts-cook'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 Breonna Roberts-cook was last updated on March 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.