Bryan Broderick

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

25MA12217600 Issued in NJ

Practice address

125 Paterson St
New Brunswick, NJ 08901-1962

Phone

(732) 235-6874

NPI assigned

Mar 23, 2017

Last updated

Jan 2, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

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

Internal Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rutgers Health-RWJ Scleroderma ProgramGroup PAC ID 5193764991, 390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038
• Robert Wood Johnson University Hospital - Somerset Hospital, Somerville, NJ, CCN 310048

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Rutgers Health-RWJ Scleroderma Program

  • Allergy & Immunology (Internal Medicine) Physician
  • New Brunswick, NJ
  • NPI 1679655781
  Medicare reassignment Care Compare group NPD
• Rutgers Health-RWJ Scleroderma Program

  • Psychiatry Physician
  • Piscataway, NJ
  • NPI 1033207378
  NPD
• Rutgers Health-RWJ Scleroderma Program

  • Pulmonary Disease Physician
  • New Brunswick, NJ
  • NPI 1275563611
  NPD
• Rutgers Health-RWJ Scleroderma Program

  • Allergy & Immunology Physician
  • New Brunswick, NJ
  • NPI 1619059011
  NPD (past)

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

• Robert Wood Johnson University Hospital Inc

  dba Robert Wood Johnson University Hospital Somerset

  • General Acute Care Hospital
  • Somerville, NJ
  • NPI 1003236878
  Care Compare affiliation
• Robert Wood Johnson University Hospital, Inc

  • General Acute Care Hospital
  • New Brunswick, NJ
  • NPI 1346243375
  Care Compare affiliation

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1215468053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST # 7312",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-6874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12217600",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NJ",
            "license": "25MA12217600",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "25MA12217600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "25MA12217600",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D89495",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Brill Goldberg, MD
• Lakisha Brimage
• Jorge Elias Brito de la Cruz
• Stephanie Angelica Brito, APN
• Fares Brnouti, M.D.
• Diana Brodowski, LCSW
• Susan Brooks, MD
• Kaya Brown, CNM
• Marlene Brown, M.S., BCBA
• Shantise Marna Brownridge, MA

• Pulmonary Disease Physician in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Pulmonary Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.