Broca Health LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

29743 Issued in AZ

Legal business name

BROCA HEALTH LLC

Practice address

1492 S Mill Ave
Ste. 114
Tempe, AZ 85281-5652

Phone

(480) 557-5710

Fax

(480) 557-5712

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Ignacio Cabezudo, MDNPI 1538161864

Title

Doctor

Phone

(480) 557-5710

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ignacio Nmi Cabezudo, MD

  • General Practice Physician
  • Goldsboro, NC
  • NPI 1538161864
  NPD (past) Authorized official

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1104045830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3941 E CHANDLER BLVD",
            "address_2": "STE. 106-158",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480301",
            "telephone_number": "480-557-5710",
            "fax_number": "480-557-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 S MILL AVE",
            "address_2": "STE. 114",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852815652",
            "telephone_number": "480-557-5710",
            "fax_number": "480-557-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCA HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "CABEZUDO",
        "authorized_official_first_name": "IGNACIO",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "480-557-5710",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "AZ",
            "license": "29743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP #",
            "identifier": "825512",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA #",
            "identifier": "9656031",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "636293",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE #",
            "identifier": "1583670",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET #",
            "identifier": "2Z2152",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "3267734",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN #",
            "identifier": "7910494",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ #",
            "identifier": "AZ0767110",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Brimhall, CCP
• Corinna Briseno
• Brandie Britt
• Broadway Dental LLC
• Brittany Broberg
• Broca Life Options LLC
• Amber Brodersen
• Valerie A Brodsky, D.O.
• Lauren Brogan, M.S., CCC-SLP
• Lynda Jane Broky, R. N.

• Health Maintenance Organization in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Health Maintenance Organization in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.