Individual provider Active NPI

Steven R Brodbeck, DC

  • Orthopedic Chiropractor
  • National City, CA
National Provider Identifier
1194804310
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
17026 Issued in CA
Practice address
1727 Sweetwater Rd Ste S
National City, CA 91950-7651
Phone
(619) 474-0900
Fax
(619) 474-8208
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Chiropractor 111NX0100X 17026 CA
Orthopedic Chiropractor 111NX0800X 17026 CA Primary

Addresses

Primary practice location

1727 Sweetwater Rd Ste S
National City, CA 91950-7651

Mailing address

1727 Sweetwater Rd
Suite S
National City, CA 91950-7650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120216000233 CA Practitioner - Chiropractic 8820256167 Practice locations: National City, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1727 Sweetwater Rd
Suite S
National City, CA 91950-7651
Phone (619) 474-0900

1727 Sweetwater Rd S
National City, CA 91950-7651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17026CAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1194804310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 SWEETWATER RD",
            "address_2": "SUITE S",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919507650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SWEETWATER RD STE S",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919507651",
            "telephone_number": "619-474-0900",
            "fax_number": "619-474-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODBECK",
        "first_name": "STEVEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "CA",
            "license": "17026",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CA",
            "license": "17026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.