Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brooke Lael Corcoran, PA

Individual provider Physician Assistant · NPI 1689449522

Brooke Lael Corcoran, PA is a Physician Assistant in Green Bay, Wisconsin. Graduated from Lincoln Memorial University Medical Department in 2023, 3 years ago. Practices with New Dermatology Group Ltd, a 23-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan and Wisconsin.

Years since qualifying
3
Trained at
Lincoln Memorial University Medical Department
Licensed in
MI, WI
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2360 Duck Creek Pkwy
Green Bay, WI 54303-3300
Phone: (920) 965-0345
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1606 S Stephenson Ave, Iron Mountain, MI 49801-3636 — (920) 965-0345

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 7704 (WI)
Physician Assistant Taxonomy 363A00000X · Licence 5601012169 (MI)

Record details

NPI number1689449522
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 21, 2023
Last updated in NPPESNovember 21, 2023
Certification dateNovember 20, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2023 (3 years in practice)
Group practice New Dermatology Group Ltd — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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