Melissa Marie Broderick, D.C., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA4137 Issued in MA

Practice address

70 East St
Methuen, MA 01844-4597

Phone

(978) 687-0156

Fax

(978) 687-9392

NPI assigned

Nov 14, 2006

Last updated

Dec 5, 2012By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: mbroderick46879@tuftsmedicine.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greater Lowell Chiropractic & Rehabilitation Inc

  • Chiropractor
  • Lowell, MA
  • NPI 1588759039
  Medicare reassignment
• Corporate Chiropractic, Inc.

  • Chiropractor
  • Lowell, MA
  • NPI 1699847889
  NPD (past) Authorized official
• Jennifer J Bak DC PC

  dba Bak Chiropractic

  • Chiropractor
  • Wakefield, MA
  • NPI 1609944370
  NPD (past)
• LGH Professional Services LLC

  • Internal Medicine Physician
  • Lowell, MA
  • NPI 1417485541
  NPD (past)
• New Beginnings Family Chiropractic Center LLC

  • Health Maintenance Organization
  • Wakefield, MA
  • NPI 1942636576
  NPD (past)
• New England Health and Wellness LLC

  • Family Medicine Physician
  • Chelmsford, MA
  • NPI 1316212384
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1144392234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 EAST ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444597",
            "telephone_number": "978-687-0156",
            "fax_number": "978-687-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 EAST ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444597",
            "telephone_number": "978-687-0156",
            "fax_number": "978-687-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C., PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2696",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y37019",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3456328",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adam Broughton, PA
• Amy Ruth Brown, LPN
• Hayley Brown, CTRS, CIFT
• Ruth-Anne Bryan, COTA/L
• Emily Andrews Buck, PMHNP-BC

• Physician Assistant in Methuen, MA
• Providers in Methuen, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.