Gordon Brodie, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

017993 Issued in CT

Practice address

375 E Center St
Manchester, CT 06040-4445

Phone

(860) 646-0166

Fax

(860) 643-7574

NPI assigned

Mar 8, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Family Practice

Education

Jefferson Medical College of Thomas Jefferson University, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gordonbrodie@mpp.allscriptsdirect.net

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.

• Prospect CT Medical Foundation, Inc.

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1144677568
  Medicare reassignment Care Compare group NPD
• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053
  Medicare reassignment NPD
• Hartford Healthcare Medical Group, Inc

  • Surgery Physician
  • Wethersfield, CT
  • NPI 1043561301
  Medicare reassignment
• Medical Access P.C.

  • Urgent Care Clinic/Center
  • Germantown, MD
  • NPI 1144291204
  NPD

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

• Manchester Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Manchester, CT
  • NPI 1881564664
  Care Compare affiliation

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1114995016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3249",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060662149",
            "telephone_number": "860-872-2289",
            "fax_number": "860-896-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404445",
            "telephone_number": "860-646-0166",
            "fax_number": "860-643-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODIE",
        "first_name": "GORDON",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "017993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "080139932",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jayla Charllette Bridges, LMSW
• Michael A Briscoe, CLINICAL THERAPIST
• Stephanie Marie Brito
• Jenna Nicole Britton, LMSW
• Krista Brodginski, OTR/L
• Alaina Jeanne Brokaw
• Dorothy Bromfield
• Brad Brooks, DO
• Chantol T Brown-Scully
• Bernadette Brown

• Family Medicine Physician in Manchester, CT
• Providers in Manchester, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.