BROOKE LEE SKINNER (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1659038669

BROOKE LEE SKINNER (PHYSICIAN ASSISTANT) is a healthcare provider. based in Chubbuck, Idaho. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PHYSICIAN ASSISTANT. They hold a License No. PA-2154 (ID). The NPI Number for BROOKE LEE SKINNER (PHYSICIAN ASSISTANT) is 1659038669

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
BROOKE LEE SKINNER (PHYSICIAN ASSISTANT)
NPI
1659038669
Phone
(208) 251-8700
Address
4728 REVOLUTION RD
Enumeration Date
24 November 2021
Last Update Date
18 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2082342300
Graduation Year
2021 (5 years ago)
PAC ID
3072908755
Group Practice PAC ID
4082699574
Professional Enrollment ID
I20220315002734
Address ID
ID832015824PO110XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,534 PHYSICIAN ASSISTANT in ID

Provider Addresses for BROOKE LEE SKINNER (PHYSICIAN ASSISTANT)

  • 4728 REVOLUTION RD

    CHUBBUCK, ID 832021986

    Phone: (208) 251-8700

    Type: Mailing

  • 110 VISTA DR

    POCATELLO, ID 832015824

    Phone: (208) 234-2300

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $40.

Total Amount is formed as General ($40) + Research ($0) + Ownership ($0) = $40.

Last reported payment date: 2024-04-23 • Largest payer in this snapshot: Phathom Pharmaceuticals, Inc. ($22).

Total Amount

$40

General + Research + Ownership

Payments

2

Total payment records

General Amount

$40

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-04-23

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-03-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220315002734IPhysician AssistantIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes1817$0
99213Established patient office or other outpatient visit, 20-29 minutes1614$0
36415Insertion of needle into vein for collection of blood sample1111$0
View full utilization report →

Insurance plans in this area (ZIP 83202)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082699574View full group profile
NameSpecialtyState
Family PracticeID
Physician AssistantID
Nurse PractitionerID
Family PracticeID

Reviews

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Frequently asked questions

What unique ID ties claims to BROOKE LEE SKINNER (PHYSICIAN ASSISTANT)?
NPI 1659038669 is assigned to BROOKE LEE SKINNER (PHYSICIAN ASSISTANT) under the national enumeration system.
Is BROOKE LEE SKINNER (PHYSICIAN ASSISTANT) active in the national directory?
BROOKE LEE SKINNER (PHYSICIAN ASSISTANT)'s public NPI profile is in an active state.
What kind of provider is BROOKE LEE SKINNER (PHYSICIAN ASSISTANT)?
The page reflects Physician Assistant for BROOKE LEE SKINNER (PHYSICIAN ASSISTANT). Clinical services aligned with this taxonomy classification.
What location shows for BROOKE LEE SKINNER (PHYSICIAN ASSISTANT)?
We surface Chubbuck, Idaho for BROOKE LEE SKINNER (PHYSICIAN ASSISTANT) based on available NPPES addresses.
How can I contact BROOKE LEE SKINNER (PHYSICIAN ASSISTANT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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