Heather Dawn Brock, is a medicare enrolled "Nurse Practitioner - Family" in Eglin, Florida. She graduated from nursing school in 2021 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Santa Rosa Hma Physician Management, Llc, Ibrahim Heart Clinic Pllc and her current practice location is
307 Boatner Rd Ste 114, Eglin, Florida. You can reach out to her office (for appointments etc.) via phone at
(850) 883-9042.
Heather Dawn Brock is licensed to practice in Florida (license number 11015727) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1003574500.
Provider's Profile
| Full Name | Heather Dawn Brock |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 4 Years |
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| Location | 307 Boatner Rd Ste 114, Eglin, Florida |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Heather Dawn Brock graduated from nursing school in 2021
NPI Data:
- NPI Number: 1003574500
- Provider Enumeration Date: 12/01/2021
- Last Update Date: 05/20/2025
Medicare PECOS Information:
- PECOS PAC ID: 8820438617
- Enrollment ID: I20240426001059
Medical Identifiers
Medical identifiers for Heather Dawn Brock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1003574500 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 1-182636 (Alabama) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 11015727 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Santa Rosa Hma Physician Management, Llc | 1658478532 | 46 |
| Ibrahim Heart Clinic Pllc | 4688958648 | 28 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Heather Dawn Brock allows following entities to bill medicare on her behalf.
| Entity Name | Santa Rosa Hma Physician Management, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447365366
PECOS PAC ID: 1658478532
Enrollment ID: O20070823000556 |
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| Entity Name | Ibrahim Heart Clinic Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1629511035
PECOS PAC ID: 4688958648
Enrollment ID: O20170313000103 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Heather Dawn Brock is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Heather Dawn Brock,
307 Boatner Rd Ste 114,
Eglin, FL 32542-1302
Ph: () - | Heather Dawn Brock,
307 Boatner Rd Ste 114,
Eglin, FL 32542-1302
Ph: (850) 883-9042 |
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