Tim Alan Broeseker, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

ME0047148 Issued in FL

Practice address

1300 Miccosukee Road
TMPP - Cancer & Hematology
Tallahassee, FL 32308

Phone

(850) 431-5360

Fax

(850) 431-5367

NPI assigned

Oct 10, 2006

Last updated

Jan 4, 2012By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Hematology Oncology Associates of Northwest Florida LLP

  • Hematology & Oncology Physician
  • Tallahassee, FL
  • NPI 1366566077
  NPD
• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1093803777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE ROAD",
            "address_2": "TMPP - CANCER & HEMATOLOGY",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32308",
            "telephone_number": "850-431-5360",
            "fax_number": "850-431-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE ROAD",
            "address_2": "TMPP - CANCER & HEMATOLOGY",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32308",
            "telephone_number": "850-431-5360",
            "fax_number": "850-431-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROESEKER",
        "first_name": "TIM",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME0047148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05945",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048530600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Byron Brocco, LCSW
• Amanda Lynn Brock
• Katie Carroll Brock, NBH-WHC
• Mary M Brock, R.N.
• Debra Lynn Broderick
• Lynda A Brogdon, PH.D,
• Brenda Lee Broger, ARNP
• Lauren Brognano
• Sevilla Bronson
• Brookdale Senior Living Communities, Inc. (Brookdale Centre Pointe Boulevard)

• Hematology & Oncology Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.