CMS-1500 Box 24J / 33a • NPI
1689449522
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363A00000X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant
Box 32 Service Location & ZIP+4
2360 DUCK CREEK PKWY, GREEN BAY, WI, 54303-3300
✓ 9-Digit EDI 837 ZIP+4 (54303-3300)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1689449522 (BROOKE LAEL CORCORAN, PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1689449522)
Medicare Beneficiaries
175
Total Billed Services
581
Distinct CPT/HCPCS Codes
16
Medicare Allowed Total
$26,980.34
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
11102 | Biopsy of related skin growth, first growth | 54 |
11103 | Biopsy of related skin growth, each additional growth | 19 |
17000 | Destruction of precancer skin growth, 1 growth | 65 |
17003 | Destruction of precancer skin growth, 2-14 growths | 226 |
17110 | Destruction of skin growth, 1-14 growths | 20 |
99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 51 |
99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 11 |
99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 103 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Clobetasol Propionate Clobetasol Propionate | 71 | 42 |
| Ketoconazole Ketoconazole | 57 | 34 |
| Mupirocin Mupirocin | 18 | 14 |
| Triamcinolone Acetonide Triamcinolone Acetonide | 78 | 60 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1689449522 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | BROOKE LAEL CORCORAN, PA |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: 363A00000X (Physician Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 2360 DUCK CREEK PKWY, GREEN BAY, WI, 54303-3300 |
| Practice Telephone / Fax | Tel: (920) 965-0345 |
| Administrative Mailing Address | 4016 KIRKSVILLE RD, LANCASTER, KY, 40444-8659 |
| Enumeration & Last Sync | Enumerated: 2023-11-21 | CMS Record Updated: 2023-11-21 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363A00000X)
What Does Taxonomy Code 363A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BROOKE LAEL CORCORAN, PA)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: WI | License: 7704 | Primary: Yes (Primary) |
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: MI | License: 5601012169 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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