Crystal N Broussard, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

69764 Issued in NJ

Practice address

466 Old Hook Rd
Suite 1
Emerson, NJ 07630-1396

Phone

(201) 967-8221

Fax

(201) 634-9647

NPI assigned

Jun 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

GastroenterologyAlso: Internal Medicine

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley Hospital Hospital, Paramus, NJ, CCN 310012
• Hackensack Meridian Health Pascack Valley Medical Hospital, Westwood, NJ, CCN 310130

Merit-based Incentive Payment System (MIPS)

Final score

96.09 of 100Reported as apm

Quality

86.89

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbroussard189459@ahs.direct-ci.com

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.

• MPV New Jersey MD Services PC

  • General Practice Physician
  • Westwood, NJ
  • NPI 1215391271
  Medicare reassignment Care Compare group NPD
• Premier Medical Alliance LLC

  • Gastroenterology Physician
  • Emerson, NJ
  • NPI 1093142895
  Medicare reassignment NPD
• MPV New Jersey MD Services PC

  • Durable Medical Equipment & Medical Supplies
  • Bloomfield, NJ
  • NPI 1801542816
  NPD

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

• Pascack Valley Hospital LLC

  • General Acute Care Hospital
  • Westwood, NJ
  • NPI 1205176062
  Care Compare affiliation
• The Valley Hospital Inc.

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1013912633
  Care Compare affiliation

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114955846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 LINCOLN AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522312",
            "telephone_number": "973-762-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 OLD HOOK RD",
            "address_2": "SUITE 1",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301396",
            "telephone_number": "201-967-8221",
            "fax_number": "201-634-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "CRYSTAL",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "69764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Bray, MSRD CDN
• Brea Emeritus
• Brea Emerson, LLC
• Karen Breidenbach, RPH
• Alan J Briker, MD
• Tiara C Brown, PHD
• Raymond B Calantone, DMD
• William L Cantor, M.D.
• Ashley M. Caprio, OTR/L
• Brenda M. Christensen, M.D.

• Gastroenterology Physician in Emerson, NJ
• Providers in Emerson, NJ by specialty
• Gastroenterology Physician in New Jersey

• 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; 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.