Robert Broderick, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

141375 Issued in NY

Practice address

1355 Northern Blvd
Ste 300
Manhasset, NY 11030-3023

Phone

(516) 627-3232

Fax

(516) 365-1893

NPI assigned

Jun 13, 2005

Sex

Male

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 NY

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

OphthalmologyAlso: General Surgery

Education

New York Medical College, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ophthalmic Consultants of Long IslandGroup PAC ID 8022909076, 107 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (2 of 6)

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: robert.broderick.p1@direct.ocli.nextgenshare.com

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.

• Ophthalmic Consultants of Long Island

  • Ophthalmology Physician
  • Rockville Centre, NY
  • NPI 1285675660

  NY, Ophthalmology

  Medicare reassignment Care Compare group NPD
• Ophthalmic Consultants of Long Island

  • Durable Medical Equipment & Medical Supplies
  • Huntington, NY
  • NPI 1154830701
  Care Compare group
• Ophthalmic Consultants of Long Island

  • Ophthalmology Physician
  • Stony Brook, NY
  • NPI 1245271600

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1275537656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E GATE BLVD STE 111",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302136",
            "telephone_number": "516-804-5200",
            "fax_number": "516-240-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 NORTHERN BLVD",
            "address_2": "STE 300",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303023",
            "telephone_number": "516-627-3232",
            "fax_number": "516-365-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "141375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508649",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank-Uwe Breuer, MD
• Jay William Bridbord, D.D.S.
• Julia Briggs
• Victoria Brocious
• Monica Broderick, M.D.
• Judith Brody, MD
• Neil Irwin Brody, MD, PHD
• Anna Maria Broniek, CCC-SLP
• Christopher Jordan Brooks, PA-C
• Steven Jacob Brooks, DO, FAOCD, MS

• All providers in Manhasset, NY
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.