Maryanna Kathryn Brockman, PA-C, ATC
NPI 1912405531ActiveIndividual· Physician Assistant· Middletown, OH
Physician Assistant (PA-C, ATC) in Middletown, Ohio, trained at Southern Illinois University School of Medicine (class of 2022). 145 Medicare patients in 2024, $19,547 paid; all of their 412 Part D prescriptions were generic.
Overview
| NPI | 1912405531 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C, ATC |
| Sole proprietor | No |
| NPI issued | Jan 29, 2018 |
| Last updated in NPPES | Aug 19, 2025 |
| Certified by provider | Aug 19, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 50.007758RX | OH |
| Specialist/Technologist, Athletic Trainer | 2255A2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (OH) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 145 |
|---|---|
| Services billed | 784 across 32 procedure codes |
| Paid by Medicare | $19,547 |
Part D prescriptions in 2024
| Prescriptions (claims) | 412 · 416 30-day fills |
|---|---|
| Patients | 184 |
| Total drug cost | $2,242 |
| Generic share | 100% of claims |
Education and affiliations
| Medical school | Southern Illinois University School of Medicine |
|---|---|
| Graduation year | 2022 |
| Medicare specialty | Physician Assistant |
Medical group
- Premier Health Specialists IncDayton, OH · 580 clinicians
Hospital affiliation
- Atrium Medical CenterFranklin, OH
Other facilities
- Fidelity Health CareHome health agency · Moraine, OH
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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