Marc Allen Broberg, PT

Primary specialty

Neurology Physical TherapistTaxonomy code 2251N0400X

License

27877 Issued in CA

Practice address

3418 Loma Vista Rd
Suite a
Ventura, CA 93003-3016

Phone

(805) 410-1363

NPI assigned

Oct 29, 2011

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Two Trees Physical Therapy and Wellness IncGroup PAC ID 5597915603, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Two Trees Physical Therapy & Wellness Inc

  • Physical Therapist
  • Ventura, CA
  • NPI 1770830325

  Neurology

  Medicare reassignment Care Compare group NPD
• Two Trees Physical Therapy & Wellness Inc

  • Physical Therapist
  • Ventura, CA
  • NPI 1205453305
  NPD

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

{
    "created_epoch": "1319846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1285910679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 LOMA VISTA RD",
            "address_2": "SUITE A",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033016",
            "telephone_number": "805-223-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 LOMA VISTA RD",
            "address_2": "SUITE A",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033016",
            "telephone_number": "805-410-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROBERG",
        "first_name": "MARC",
        "middle_name": "ALLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-29",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "CA",
            "license": "27877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kacie Brinkley
• Roma Lynda Brister, RN
• Carie Lavelle Bristow, LPCC
• Miyu Broadie
• Barbara Broberg, L.P.T.
• Ian James Brock
• Nathan Brodie
• Aurora Leticia Broida
• Allyson Brome, D.O.
• Theresa Lee Broms, N.P.

• Neurology Physical Therapist in Ventura, CA
• Providers in Ventura, CA by specialty
• Neurology Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.