Lydia Elizabeth Broussard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

221587 Issued in AK

Practice address

2925 Debarr Rd Ste 240
Anchorage, AK 99508-2959

Phone

(907) 339-4650

NPI assigned

Feb 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, AK2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

NeuroversionGroup PAC ID 7012297062, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
• Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017

Merit-based Incentive Payment System (MIPS)

Final score

93.68 of 100Reported as group

Quality

82.26

Promoting interoperability

99

Improvement activities

40

Cost

76.32

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

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

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.

• Neuroversion

  • Interventional Pain Medicine Physician
  • Anchorage, AK
  • NPI 1487102208
  Medicare reassignment Care Compare group
• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment

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

• Galen Hospital Alaska, Inc.

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1952348047
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1053363119
  Care Compare affiliation

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1104572478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 DEBARR RD STE 240",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082959",
            "telephone_number": "907-339-4650",
            "fax_number": "907-339-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 DEBARR RD STE 240",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082959",
            "telephone_number": "907-339-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "LYDIA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15445",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "221587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Ann Brothers McNeil, PA-C
• Ida Brothers
• Johnathan Brothers
• Marshall Brothers
• Naomi Brothers
• Stacey Marie Browder, LPN
• Lena Brower
• Clint Browers, LPN
• Martha Brown Truncale, D.M.D.
• Cynthia Brown-Williams

• Physician Assistant in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.