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Physician Compare National (NPI:1962955807)

HEALTHCARE PROVIDER: BROOKE GELECKI NP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1962955807
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 4688968688
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20190912000406
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name GELECKI
Individual professional last name
Provider First Name BROOKE
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2016
Individual professional's medical school graduation year
Primary Specialty NURSE PRACTITIONER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name LAS CRUCES PHYSICIAN PRACTICES, LLC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 7618974858
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 50
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 150 N ROADRUNNER PKWY
Group Practice or individual's line 1 address
City LAS CRUCES
Group Practice or individual's city
State NM
Group Practice or individual's state
Zip Code 880117044
Group Practice or individual's zip code (9 digits when available)
Phone Number 5755566440
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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