Jennifer L Broome, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0056149 Issued in MD

Practice address

1708 W. Rogers Ave
Baltimore, MD 21209-4596

Phone

(410) 578-8600

NPI assigned

Oct 5, 2006

Last updated

Jan 28, 2015By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pavilion Pediatrics at Greenspring Station, PA

  • Pediatrics Physician
  • Lutherville, MD
  • NPI 1134270168
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1144316068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10755 FALLS RD",
            "address_2": "SUITE 260",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210934515",
            "telephone_number": "410-583-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 W. ROGERS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094596",
            "telephone_number": "410-578-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0056149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402495800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyneshai Yolanda Brooks
• W. Abdullah Brooks, MD, MPH
• Yvette Brooks, PA-C
• Zhavez Brooks
• Danielle M Broome, PA
• Micah Brosbe, PH.D.
• Anna Danielle Broshkevitch
• Daniel J Brotman, M.D.
• Steven Brotman, M.D.
• Mikita Brottman, PH.D, C.T.

• Pediatrics Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.