Julianne M Wysocki Broadwater, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS16421 Issued in FL

Practice address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Phone

(386) 425-2285

Fax

(386) 425-7522

NPI assigned

Jun 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DE, FL, VT, NH4 enrollments

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 4

Specialty

Emergency Medicine

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bluewater Emergency Partners of Brunswick, LLCGroup PAC ID 3375774227, 151 clinicians

New Hampshire Emergency Physician Associates PCGroup PAC ID 2668735580, 25 clinicians

Halifax Healthcare Systems IncGroup PAC ID 1254238090, 345 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Valley Regional Hospital Hospital, Claremont, NH, CCN 301308
• Monadnock Community Hospital Hospital, Peterborough, NH, CCN 301309
• Brattleboro Memorial Hospital Hospital, Brattleboro, VT, CCN 470011
• Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017
• Halifax Health /Uf Health Medical Center of Delton Hospital, Deltona, FL, CCN 100330

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: vrhjwysoc@yourcarecommunity.org

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.

• Halifax Healthcare Systems Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Bluewater Emergency Partners of Brunswick, LLC

  • Emergency Medicine Physician
  • Brunswick, ME
  • NPI 1043640204

  NH, VT

  Medicare reassignment Care Compare group NPD
• New Hampshire Emergency Physician Associates PC

  • Emergency Medicine Physician
  • Wolfeboro, NH
  • NPI 1629578000
  Medicare reassignment Care Compare group NPD
• Bayhealth Emergency Physicians LLC

  • Emergency Medicine Physician
  • Dover, DE
  • NPI 1073012696
  Medicare reassignment NPD
• Bayhealth Medical Center, Inc.

  • Emergency Medicine Physician
  • Dover, DE
  • NPI 1679072144
  Medicare reassignment NPD
• Valley Regional Hospital Inc.

  • Critical Access Hospital
  • Claremont, NH
  • NPI 1306933619
  Medicare reassignment NPD
• Bayhealth Medical Center, Inc

  • Gastroenterology Physician
  • Milford, DE
  • NPI 1639938525
  NPD
• Monadnock Community Hospital

  • Critical Access Hospital
  • Peterborough, NH
  • NPI 1457304149
  NPD
• Valley Regional Hospital ,Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Claremont, NH
  • NPI 1922160035
  NPD

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

• Halifax Hospital Medical Center

  • General Acute Care Hospital
  • Daytona Beach, FL
  • NPI 1811991227
  Care Compare affiliation
• Medical Center of Deltona, Inc.

  • General Acute Care Hospital
  • Deltona, FL
  • NPI 1003465097
  Care Compare affiliation
• Brattleboro Memorial Hospital

  • General Acute Care Hospital
  • Brattleboro, VT
  • NPI 1306849708
  Care Compare affiliation
• Monadnock Community Hospital

  • Critical Access Hospital
  • Peterborough, NH
  • NPI 1457304149
  Care Compare affiliation
• Monadnock Community Hospital

  • Critical Access Hospital
  • Peterborough, NH
  • NPI 1881676104
  Care Compare affiliation
• Valley Regional Hospital Inc.

  • Critical Access Hospital
  • Claremont, NH
  • NPI 1306933619
  Care Compare affiliation

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1124255203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-226-4590",
            "fax_number": "386-226-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "386-425-2285",
            "fax_number": "386-425-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSOCKI BROADWATER",
        "first_name": "JULIANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS16421",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS16421",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS16421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jimmy Allen Wyatt, PA-C
• Sharniece Wyatt
• Alik Wyche
• Laurence T Wylie
• Cheryl J Wynn, DPT
• Yifan Xing
• Katerina Xu, PHARMD
• Donna C Xynidis, MS, SLP
• Theodore E Yaeger IV, M.D.
• Mehran Yaghmaie, MD

• Emergency Medicine Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.