Talmage Jay Broadbent, MD,PHD

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

MD60704061 Issued in WA

Practice address

626 S. Sheridan St
Spokane, WA 99202-1325

Phone

(509) 279-2176

Fax

(509) 279-2941

NPI assigned

Jul 7, 2011

Last updated

Feb 8, 2023By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Ophthalmology

Education

University of Utah School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Eyelid and Orbital Specialists PSGroup PAC ID 9133252935, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

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.

• Northwest Eyelid and Orbital Specialists, P.S.

  • Ophthalmology Physician
  • Spokane, WA
  • NPI 1053637702
  Medicare reassignment Care Compare group NPD
• Northwest Eyelid and Orbital Specialists PS

  • Ambulatory Surgical Clinic/Center
  • Spokane, WA
  • NPI 1871929646
  NPD
• Pasco Vision Clinic P S

  • Optometrist
  • Pasco, WA
  • NPI 1104851690
  NPD (past)

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

• Providence Health & Services - Wa

  dba Prov Scred Hrt Med Ctr & Chlds Hos

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1043507205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 S. SHERIDAN ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021325",
            "telephone_number": "509-279-2176",
            "fax_number": "509-279-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 S. SHERIDAN ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021325",
            "telephone_number": "509-279-2176",
            "fax_number": "509-279-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADBENT",
        "first_name": "TALMAGE",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "MD,PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "58899",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD60704061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2079499",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Venette Marie Brito-Melo, LMHC
• Terry Wayne Britt
• Brittany Aguila Therapy, LLC
• Brittany Haugen Counseling PLLC
• Rebecca Britton
• Jessica Marie Broadfield, MA, LMHCA
• Ivy Raine Broadrick
• Alexis Stephen Brock, RN
• Greg R Brockbank, DPM
• Ethan Lee Brockett, DDS

• Ophthalmic Plastic and Reconstructive Surgery Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.