Individual provider Active NPI

Steven J Bromberg, D.C.

  • Sports Physician Chiropractor
  • Cambridge, MA
National Provider Identifier
1063555787
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
995 Issued in MA
Practice address
201 Broadway
Cambridge, MA 02139-1955
Phone
(617) 494-1166
Fax
(617) 494-0915
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 995 MA Primary

Addresses

Primary practice location

201 Broadway
Cambridge, MA 02139-1955

Mailing address

201 Broadway
Cambridge, MA 02139-1955
Phone (617) 494-1166

Other identifiers 1

IdentifierTypeStateIssuer
352352OtherMAHARVARD PILGRIM HEALTH CA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060427000530 MA Practitioner - Chiropractic 2163432634 Practice locations: Cambridge, MA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

201 Broadway
Cambridge, MA 02139-1955
Phone (617) 494-1166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
995MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Steven Bromberg DC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063555787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BROADWAY",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391955",
            "telephone_number": "617-494-1166",
            "fax_number": "617-494-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 BROADWAY",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021391955",
            "telephone_number": "617-494-1166",
            "fax_number": "617-494-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMBERG",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MA",
            "license": "995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH CA",
            "identifier": "352352",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.