Andrew Michael Broadsword, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D9961 Issued in OR

Practice address

700 NE Multnomah St Ste 880
Portland, OR 97232-4118

Phone

(503) 230-1234

Fax

(503) 239-7741

NPI assigned

Sep 17, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 20, 2017 through Apr 20, 2027

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Endodontic Associates, P.C.

  • Endodontics
  • Portland, OR
  • NPI 1356348379
  NPD (past)

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1285060632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NE MULTNOMAH ST STE 880",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972324118",
            "telephone_number": "503-230-1234",
            "fax_number": "503-239-7741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NE MULTNOMAH ST STE 880",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972324118",
            "telephone_number": "503-230-1234",
            "fax_number": "503-239-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADSWORD",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-17",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D9961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Bro
• Tova Broadbent
• Broader Path Therapy LLC
• Sarah Broadhead, MFT-A
• Lisa Denise Broadous
• Jonathon Broadwater
• Broadway Cab, LLC (Broadway Cab)
• Broadway Dental, P.C. (dr. goodman-cherrier, p.c.)
• Broadway Foot & Ankle Clinic, PC
• Broadway Medical Clinic LLP

• Endodontics in Portland, OR
• Providers in Portland, OR by specialty
• Endodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.