Janessa Marie Broussard

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95007103 Issued in CA

Practice address

470 Castro St
San Francisco, CA 94114-2482

Phone

(415) 581-1600

Fax

(415) 581-1610

NPI assigned

Aug 4, 2017

Sex

Female

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• City & County of San Francisco

  dba San Francisco Public Health Laboratory

  • Clinical Medical Laboratory
  • San Francisco, CA
  • NPI 1982737524
  Medicare reassignment NPD
• UCSF Medical Group Business Services

  • Internal Medicine Physician
  • San Francisco, CA
  • NPI 1477624104
  Medicare reassignment NPD
• University of California San Francisco

  dba UCSF Pediatrics Group

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1861578973
  Medicare reassignment NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Dept of Otolaryngology

  • Otolaryngology Physician
  • San Francisco, CA
  • NPI 1154396208
  Medicare reassignment NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Dept of Hematology

  • Hematology (Internal Medicine) Physician
  • San Francisco, CA
  • NPI 1326013442
  Medicare reassignment NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Dept of Infectious Disease

  • Infectious Disease Physician
  • San Francisco, CA
  • NPI 1366417933
  Medicare reassignment NPD
• City & County of San Francisco

  dba CCSF DPH Multi - Practice Medical Group

  • Community Health/Public Health Clinical Nurse Specialist
  • San Francisco, CA
  • NPI 1609041060
  NPD
• City and County of San Francisco

  dba DSAAM OTOP Methadone Maintenance

  • Methadone Clinic
  • San Francisco, CA
  • NPI 1578787925
  NPD
• UCSF Medical Group Business Services

  dba UCSF Orthotic and Prosthetic Center - Gateway Medical Building

  • Health Service Clinic/Center
  • San Francisco, CA
  • NPI 1194115246
  NPD
• University of California San Francisco

  dba UCSF Outpatient Pharmacy at Parnassus

  • Community/Retail Pharmacy
  • San Francisco, CA
  • NPI 1659141711
  NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Division of Vascular Surgery

  • Vascular Surgery Physician
  • San Francisco, CA
  • NPI 1033913959
  NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Dept of Medical Oncology

  • Medical Oncology Physician
  • San Francisco, CA
  • NPI 1386619419
  NPD

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1285159871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 CASTRO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941142482",
            "telephone_number": "415-581-1600",
            "fax_number": "415-581-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 CASTRO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941142482",
            "telephone_number": "415-581-1600",
            "fax_number": "415-581-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "JANESSA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-04",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95007103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "95007103",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Broughton, R.EEGT
• Paulette Broughton
• Alexandra Broussard
• Dominique Broussard
• Imari Broussard
• Jia Mae-Aimee Broussard, ASW
• Sharon Broussard
• Trenay Broussard, CPT-I
• Timothy D Browder, M.D.
• Dennis Kyle Browe

• Primary Care Nurse Practitioner in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.