Alexandra Brodka, MD
Individual provider Active NPI Family Medicine Physician · Casper, WY
NPI 1356911754 · NPPES record last updated Jun 24, 2024
Key facts
- NPI
- 1356911754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 16980A (WY)
- Practice address
- 1020 S Conwell St
Casper, WY 82601-3921 - Phone
- (307) 265-8300
- NPI assigned
- Jun 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Banner Health Physicians West LLC
Practice addresses (Care Compare)
1020 S Conwell St
Casper, WY 82601-3921
Phone (307) 265-8300
Hospital & facility affiliations
- Central Wyoming Hospice Program
- Banner Wyoming Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.9 of 100
- Quality
- 68.13
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 69.04
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240702003225 | WY | Practitioner - Family Practice | 6800298688 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16980A | WY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Banner Health Physicians West LLC | Single Specialty | Current |
Accepting new patients |
| Banner Health Physicians West LLC | Single Specialty | Current |
Accepting new patients |
Locations
1020 S Conwell St
Casper, WY 82601
Phone (307) 265-3622
1106 Big Horn Ave
Worland, WY 82401
Phone (307) 347-3221
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 16980A | WY | Yes |
Addresses
Primary practice location
1020 S Conwell St
Casper, WY 82601-3921
Mailing address
1020 S Conwell St
Casper, WY 82601-3921
Phone (307) 265-8300
Other providers in Casper, WY
- Cecilia Renee Brimmer
- Sarah Bristow
- Delaine Marie Britt
- Kristin Ann Britt
- Nathaniel Britt
- Brook Trout Dental, P.C
- Brookridge Counseling Services Inc
- Julie Kristen Browall
- Kammi Jo Brower
- Valerie L Brower
All providers in Casper, WY · Family Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.