BROOKE M TENNIS
NPI 1720963572
Nurse Practitioner - Family in Amsterdam, NY
About Brooke M Tennis NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BROOKE M TENNIS (NPI 1720963572) is an individual family provider in Amsterdam, New York, licensed in New York (F357184-01) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS, is affiliated with St Mary's Healthcare, and is a graduate of Other (2025).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Brooke M Tennis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Brooke Tennis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Amsterdam, NY 12010
- Reassigned Medicare billing, New York enrollment
- 3 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Mary's Healthcare
Acute Care Hospitals · Amsterdam, NYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 12010 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Tennis's NPI number?
The NPI number for Brooke Tennis is 1720963572. It was assigned to this individual provider in the NPPES registry on August 11, 2025.
Where is Brooke Tennis located?
Brooke Tennis practices at 5010 State Highway 30 Ste 204, Amsterdam, NY 12010. The listed phone number is (518) 842-8185.
What is Brooke Tennis's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Brooke Tennis enrolled in Medicare?
Yes. Brooke Tennis is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Brooke Tennis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Brooke Tennis reassigns Medicare benefits to Family Ear Nose And Throat Care PC (Amsterdam, NY). 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 Tennis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Brooke Tennis affiliated with any hospitals?
According to CMS data, Brooke Tennis is affiliated with St Mary's Healthcare.
When was this NPI record last updated?
The NPPES record for Brooke Tennis was last updated on August 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Brooke M Tennis · NPI 1720963572
Family physician in Amsterdam, New York. Individual provider, active in the CMS NPPES registry since August 11, 2025.
## Identity
- **NPI:** 1720963572 (Entity type: Individual)
- **Enumerated:** August 11, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** F357184-01 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 5010 STATE HIGHWAY 30 STE 204, Amsterdam, NY 12010-7532
- **Phone:** (518) 842-8185
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Family Ear Nose And Throat Care PC (NPI 1801971817, Amsterdam, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** August 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1720963572) · Data from the CMS NPPES public registry.