BROCK CHAMBERLAIN – Physician Assistant, NPI 1356992515
Physician Assistant
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,032 PHYSICIAN ASSISTANT in OH
Provider Addresses for BROCK CHAMBERLAIN
2109 Loxley Rd
Toledo, OH 436135014
Phone: (419) 466-5012
Type: Location
130 Morris Rd
Circleville, OH 431131362
Phone: (740) 477-6511
Fax: (740) 477-6888
Type: Location
130, Morris Road, Northwood Park, Circleville, Pickaway County, Ohio, 43113, United States
CIRCLEVILLE, OH 431131362
Phone: (740) 477-6511
Fax: (740) 477-6888
Type: Mailing
PO BOX 751461
CHARLOTTE, NC 282751461
Phone: (843) 792-6200
Type: Mailing
171 ASHLEY AVE
CHARLESTON, SC 294251362
Phone: (843) 792-1414
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2023-11-29 • Largest payer in this snapshot: Stryker Corporation ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-11-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $13 |
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: 2023-01-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20200413003709 | I | Physician Assistant | OH | TBD |
| I20230106001457 | I | Physician Assistant | SC | 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 43613)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Critical Care (Intensivists) | NC | |
| - | NC | |
| - | NC | |
| - | NC | |
| - | NC | |
| - | NC | |
| - | NC | |
| - | NC | |
| General Surgery | TX | |
| - | NC |
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