Mark E Brodsky, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C53623 Issued in CA

Practice address

3705 Mission Blvd
San Diego, CA 92109-7104

Phone

(619) 515-2444

NPI assigned

Oct 6, 2006

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

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

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Health Centers of San Diego IncGroup PAC ID 3476446378, 299 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment Care Compare group NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1700821303
  NPD
• Nopah Vista Emergency Physicians LLC

  • Emergency Medicine Physician
  • Pahrump, NV
  • NPI 1396794095
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1346337904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-906-4623",
            "fax_number": "619-906-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MISSION BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921097104",
            "telephone_number": "619-515-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODSKY",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C53623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan C Broderick, M.D
• James Sean Brodfuehrer, DDS
• Fred Joseph Brodie, DIVE IDC
• Michelle Marie Brodie, MS
• Kyle Brodmann, M.D.
• Rachel Brodsky
• Roxanne Brodsky
• Dora L Brody, IMF
• Jason Brody
• Steven Andrew Brody, M.D.

• Family Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.
• 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.