Kevin J Broderick, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

204113 Issued in MA

Practice address

1 Compass Way
Suite 102
East Bridgewater, MA 02333-1465

Phone

(508) 350-2100

Fax

(508) 350-2314

NPI assigned

Jun 1, 2006

Last updated

Mar 7, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nova Medical Group PCGroup PAC ID 9133661580, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brockton Vna Home health agency, Brockton, MA, CCN 227006
• Bayada Home Health Care Inc Home health agency, Plymouth, MA, CCN 227537
• South Shore Visiting Nurse Association Home health agency, Rockland, MA, CCN 227082
• Centerwell Home Health Home health agency, Fall River, MA, CCN 227260
• Croi Health Home health agency, Norwell, MA, CCN 227241
• South Shore Hospital Hospital, South Weymouth, MA, CCN 220100
• Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052
• Good Samaritan Medical Center Hospital, Brockton, MA, CCN 220111

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BEDEDD/Endpoint/BEDEDD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nova Medical Group PC

  • Family Medicine Physician
  • East Bridgewater, MA
  • NPI 1235991332
  Medicare reassignment Care Compare group NPD
• Steward Medical Group, Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1255600300
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Shore Hospital Inc.

  dba South Shore Visiting Nurse Association

  • Home Health Agency
  • Braintree, MA
  • NPI 1669558474
  Care Compare affiliation Name & address match
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Plymouth, MA
  • NPI 1366481293
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • South Easton, MA
  • NPI 1811257694
  Care Compare affiliation
• Boston Medical Center - South Corporation

  dba Boston Medical Center - South

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1871329110
  Care Compare affiliation
• Brockton Hospital, Inc.

  dba Signature Healthcare Brockton Hospital

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  Care Compare affiliation
• Brockton Visiting Nurse Association

  • Home Health Agency
  • Brockton, MA
  • NPI 1043213275
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  dba CenterWell Home Health

  • Home Health Agency
  • Fall River, MA
  • NPI 1538190087
  Care Compare affiliation
• Norwell Visiting Nurse Association Inc

  • Home Health Agency
  • Norwell, MA
  • NPI 1043398498
  Care Compare affiliation
• South Shore Hospital Inc.

  • General Acute Care Hospital
  • South Weymouth, MA
  • NPI 1134227606
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1013954759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 N BEDFORD ST",
            "city": "EAST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023331148",
            "telephone_number": "508-350-2350",
            "fax_number": "508-350-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COMPASS WAY",
            "address_2": "SUITE 102",
            "city": "EAST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023331465",
            "telephone_number": "508-350-2100",
            "fax_number": "508-350-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "204113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAHP",
            "identifier": "204113",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "713262",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "SX3393",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "J24406",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Bowen
• Samantha Bradshaw, LMHC
• Lori A Brightman, PT
• Brockton Hospital, Inc. (Signature Healthcare Pharmacy - EB)
• Brockton Hospital, Inc. (Signature Healthcare Pharmacy-EB)
• Shannon M Brooks, RN
• Denise R Brown, MD
• Ekaterina Bruno, CCC-SLP
• Mary F. Butler-Lappin, LICSW
• Nadia Carlevale

• Family Medicine Physician in East Bridgewater, MA
• Providers in East Bridgewater, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.