NPIMap

Individual provider Active NPI

Roderick Scott Brodhead, MD

  • Emergency Medicine Physician
  • Menomonee Falls, WI
National Provider Identifier
1356384564
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
26539 Issued in WI
Practice address
W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone
(262) 253-5400
NPI assigned
Jun 14, 2006
Last updated
Jun 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 26539 WI Primary

Addresses

Primary practice location

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538

Mailing address

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone (262) 253-5400

Other identifiers 1

IdentifierTypeStateIssuer
32084900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051129000655 WI Practitioner - Emergency Medicine 4789586322 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Wisconsin School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7901 S 6TH St
Oak Creek, WI 53154-2010
Phone (414) 346-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26539WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 9, 2020 Accepting new patients
The Howard Young Medical Center, Inc. Emergency Medicine CurrentSince Sep 15, 1998 Accepting new patients
Aspirus Eagle River Hospital & Clinics, Inc. Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 9, 2020 Accepting new patients
The Medical College of Wisconsin, Inc. Emergency Medicine Current Accepting new patients
Aspirus Eagle River Hospital, Inc. Emergency Medicine CurrentSince Sep 15, 1998 Accepting new patients
Froedtert & the Medical College of Wisconsin Community Physicians Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

7901 S 6th St
Oak Creek, WI 53154
Phone (414) 346-8000

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Interoperability endpoints

  • Direct secure messaging: rbrodhead350602@direct.froedtert.com

Organizations & group practices 7

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 2

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1356384564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W129N7055 NORTHFIELD DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530510538",
            "telephone_number": "262-253-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W129N7055 NORTHFIELD DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530510538",
            "telephone_number": "262-253-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODHEAD",
        "first_name": "RODERICK",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "26539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32084900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.