Michael H Broderdorf, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

38976 Issued in MN

Practice address

401 16TH Ave NW Ste 106
Rochester, MN 55901-1853

Phone

(507) 258-4680

NPI assigned

Mar 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.broderdorf@285882301415428.direct.elationemr.com

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.

• Minnesota Mobile Exams LLC

  • Urgent Care Clinic/Center
  • Rochester, MN
  • NPI 1255906426
  Medicare reassignment NPD
• Regina Medical Center

  • General Acute Care Hospital
  • Hastings, MN
  • NPI 1326066085
  NPD (past)

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1346209301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 16TH AVE NW STE 106",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011853",
            "telephone_number": "507-258-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 16TH AVE NW STE 106",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011853",
            "telephone_number": "507-258-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERDORF",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "MN",
            "license": "38976",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "38976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey W. Britton, M.D.
• Hajrudina Brkic, NP
• Autumn Rose Broadwater
• Michael D Broadwell, PSY.D
• Adam David Brockway, MD
• Brian William Brodersen, D.D.S.
• Wendy J Brodhagen, PA
• Michelle L Brodin, PHARMD
• Michael Brodsky, MD
• Julie K Brodt, NP

• Emergency Medicine Physician in Rochester, MN
• Providers in Rochester, MN by specialty
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.