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

Jacob Brockmann, PA-C

Individual provider Sports Medicine (Orthopaedic Surgery) Physician · NPI 1861121212

Jacob Brockmann, PA-C is a Physician Assistant in Glendale, Arizona. Qualified in 2022, 4 years ago. Practices with Toca at Banner Health LLC, a 26-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

18700 N 64th Dr Ste 205
Glendale, AZ 85308-7112
Phone: (602) 277-6211
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X · Licence 9130 (AZ)

Record details

NPI number1861121212
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 9, 2022
Last updated in NPPESJune 9, 2022
Certification dateMay 25, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Toca At Banner Health Llc — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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