Peter Broberg, MD and Associates, PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

PETER BROBERG, MD AND ASSOCIATES, PA

Practice address

4207 James Casey St Ste 305
Austin, TX 78745-1193

Phone

(512) 447-6096

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Alyson Bishop

Title

Credentialing Coordinator

Phone

(512) 447-6096

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Broberg, M.D.

  • Ophthalmology Physician
  • Austin, TX
  • NPI 1326040635
  Medicare reassignment Care Compare group NPD
• Ximena De Sabra, M.D.

  • Ophthalmology Physician
  • West Lake Hills, TX
  • NPI 1558364224
  Medicare reassignment Care Compare group NPD
• William Thomas McGlathery IV, MD

  • Ophthalmology Physician
  • Austin, TX
  • NPI 1659329555
  Medicare reassignment Care Compare group NPD
• Halsey Settle III, M.D.

  • Ophthalmology Physician
  • Austin, TX
  • NPI 1962404269
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1336246602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 JAMES CASEY ST STE 305",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451193",
            "telephone_number": "512-447-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 JAMES CASEY ST STE 305",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451193",
            "telephone_number": "512-447-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER BROBERG, MD AND ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "ALYSON",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "512-447-6096"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080183901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR MEDICARE",
            "identifier": "CG5346",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Diane Persyn, MD
• Osvaldo Hector Perurena, MD
• Carly Krumnow Peschke, CRNA
• Elijah Pesudas, LMT
• Peter a. Kangos, MD, PA
• Molly Peter, PHD
• Glenda Jean Peters-DO, M.D.
• Brian Jay Peters, D.M.D.
• Brianne Lynn Peters
• Carol L Peters, MD

• Ophthalmology Physician in Austin, TX
• Providers in Austin, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; 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.