DR. DAVID J BROCKMAN (MD) – Physical Medicine & Rehabilitation Physician, NPI 1013961929
Physical Medicine & Rehabilitation Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for DR. DAVID J BROCKMAN (MD)
Dr. Sam Fuller, MD, Generations Drive, Maple Lane, South Bend, Saint Joseph County, Indiana, 46635, United States
SOUTH BEND, IN 466351539
Phone: (574) 247-4444
Fax: (574) 243-5555
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2006-05-31
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060531000175 | I | Physical Medicine And Rehabilitation | MI | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 46635)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICAL MEDICINE AND REHABILITATIO | IN | 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 43 | 40 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| Internal Medicine | MI | |
| - | MI | |
| Gastroenterology, Internal Medicine | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Nurse Practitioner | MI | |
| N E U R O L O G Y | MI | |
| Critical Care (Intensivists), Internal Medicine, Pulmonary Disease | MI | |
| Family Practice | MI | |
| N E U R O L O G Y | GA |
Reviews
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