Mark Broadwin, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MT220054 Issued in PA

Practice address

1200 S Cedar Crest Blvd
Allentown, PA 18103-6202

Phone

(484) 862-3256

NPI assigned

May 6, 2020

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 PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1316568876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036202",
            "telephone_number": "484-862-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWIN",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT220054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Knight Brinton, D.D.S.
• Nicholas Dominick Briski
• Kenneth J Brislin, MD
• Britaz Home Care LLC
• Jon E Brndjar, D.O.
• Allison L Brobst, PAC
• Jeffrey T. Brodsky, MD
• Jaime E Broesicke, CRNP
• Traci L Broidrick, CRNP
• Joan Bromley

• Surgery Physician in Allentown, PA
• Providers in Allentown, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.