Kristina P Broderick, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

10421 E County Road 100 N
Indianapolis, IN 46234-1243

Phone

(317) 272-7013

Fax

(317) 272-7007

NPI assigned

Jun 3, 2020

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Female

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 IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

American Health Network of Indiana LLCGroup PAC ID 9830093533, 204 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Iu Health West Hospital Hospital, Avon, IN, CCN 150158
• Indiana University Health Hospital, Indianapolis, IN, CCN 150056
• Hendricks Regional Health Hospital, Danville, IN, CCN 150005

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbroderick209547@direct.optum.com

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.

• American Health Network of Indiana, LLC

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1831236272
  Medicare reassignment Care Compare group NPD
• American Health Network of Indiana LLC

  dba American Health Network of Indiana LLC/TELERADIOLOGY

  • Radiology Clinic/Center
  • New Albany, IN
  • NPI 1164304424
  NPD
• American Health Network of Indiana, LLC

  • Family Medicine Physician
  • Mulberry, IN
  • NPI 1033220017
  NPD (past)
• American Health Network of Indiana, LLC

  • Durable Medical Equipment & Medical Supplies
  • Greenfield, IN
  • NPI 1902991854
  NPD (past)

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

• Indiana University Health West Hospital Inc

  dba IU Health West Hospital

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1063443455
  Care Compare affiliation Name & address match
• Hendricks County Hospital

  • General Acute Care Hospital
  • Danville, IN
  • NPI 1669475950
  Care Compare affiliation
• Indiana University Health Inc

  dba Indiana University Health

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1144266024
  Care Compare affiliation

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1346864527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10421 E COUNTY ROAD 100 N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462341243",
            "telephone_number": "317-272-7013",
            "fax_number": "317-272-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10421 E COUNTY ROAD 100 N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462341243",
            "telephone_number": "317-272-7013",
            "fax_number": "317-272-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "KRISTINA",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-03",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ross Brockunier
• Amanda V Broderick, PHD
• Conor Thomas Broderick
• Jason R Broderick
• Jill Marie Broderick, PHARMD
• Margaret Therese Broderick
• Thaddeus Broderick
• Lauren Elizabeth Brodeur
• Jerica Nichole Brodhead, PA-C
• Christopher John Brodowicz, DDS

• Physician Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.