MARYANNA KATHRYN BROCKMAN (PA-C, ATC) – Physician Assistant, NPI 1912405531
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,036 PHYSICIAN ASSISTANT in OH
Provider Addresses for MARYANNA KATHRYN BROCKMAN (PA-C, ATC)
561 VALLEY VIEW PT
SPRINGBORO, OH 450669099
Phone: (937) 422-3449
Type: Location
HL, Grossmattstrasse, Waldegg, Birmensdorf (ZH), Bezirk Dietikon, Zurich, 8142, Switzerland
CANTON, MO 634351257
Phone: (937) 422-3449
Type: Mailing
30 CLEVENGER CT
SPRINGBORO, OH 450667429
Phone: (937) 422-3449
Type: Mailing
275 N BREIEL BLVD
MIDDLETOWN, OH 450423807
Phone: (513) 424-7711
Type: Location
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: 2022-10-17
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 |
|---|---|---|---|---|
| I20221017001138 | I | Physician Assistant | OH | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 121 | 43 | $0 |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 102 | 29 | $0 |
| 27447 | Replacement of knee joint, both sides of knee | 29 | 28 | $0 |
| 73502 | X-ray of hip, 2-3 views | 21 | 15 | $0 |
| 73562 | X-ray of knee, 3 views | 21 | 15 | $0 |
Insurance plans in this area (ZIP 45066)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hand Surgery, Orthopedic Surgery | OH | |
| Physician Assistant | OH | |
| Interventional Cardiology, Cardiac Electrophysiology | OH | |
| - | OH | |
| Cardiovascular Disease (Cardiology) | OH | |
| - | OH | |
| Physician Assistant | OH | |
| Thoracic Surgery | PA | |
| Physician Assistant | OH | |
| Physician Assistant | OH |
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