NPIMap

Individual provider Active NPI

John Broussard, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Galveston, TX
National Provider Identifier
1326509977
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
U4750 Issued in TX
Practice address
901 Harborside Dr
Galveston, TX 77550
Phone
(786) 843-7869
NPI assigned
Mar 27, 2019
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X U4750 TX Primary
General Practice Physician 208D00000X U4750 TX

Addresses

Primary practice location

901 Harborside Dr
Galveston, TX 77550

Mailing address

4119 Avenue T 1/2 Unit RR
Galveston, TX 77550-8649
Phone (786) 843-7869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240327000958 TX Practitioner - General PracticePractitioner - Pathology 6103263033 Reassigns benefits to 2 organizations
I20250320002859 CA Practitioner - PathologyPractitioner - General Practice 6103263033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Tulane University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Pathology Group IncGroup PAC ID 5698839637, 6 clinicians
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians
Austin Pathology AssociatesGroup PAC ID 7012902539, 76 clinicians

Practice addresses (Care Compare)

101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone (714) 446-7505

2101 Pease St
Harlingen, TX 78550-8307
Phone (956) 389-6565

700 E Marshall Ave
Longview, TX 75601-5580
Phone (903) 315-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of California, PC General Practice CurrentSince Mar 1, 2025 Accepting new patients
The Pathology Group, Inc. Anatomic Pathology & Clinical Pathology CurrentSince Aug 11, 2025 Accepting new patients
Signify Health Medical Associates, PLLC General Practice CurrentSince Feb 13, 2024 Accepting new patients

Locations

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

818 W 7th St
Ste 930
Los Angeles, CA 90017
Phone (800) 525-9202

505 Montgomery St
Fl 10
San Francisco, CA 94111
Phone (503) 427-8095

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1326509977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 AVENUE T 1/2 UNIT RR",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775508649",
            "telephone_number": "786-843-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 HARBORSIDE DR",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "77550",
            "telephone_number": "786-843-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "U4750",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "U4750",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.