Individual provider Active NPI

John P Broderick, DC

  • Chiropractor
  • Lowell, MA
National Provider Identifier
1396831053
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2553 Issued in MA
Practice address
249 Central St
Lowell, MA 01852-2214
Phone
(978) 452-1466
Fax
(978) 452-1826
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2553 MA Primary

Addresses

Primary practice location

249 Central St
Lowell, MA 01852-2214

Mailing address

249 Central St
Lowell, MA 01852-2214
Phone (978) 452-1466

Other practice location 1

1007 Osgood St
North Andover, MA 01845-1501
Phone (978) 557-9355

Other identifiers 6

IdentifierTypeStateIssuer
606350OtherMACIGNA
Y36807OtherMABLUE CROSS/BLUE SHIELD
468952OtherMATUFTS
63563OtherMAFALLON
PR1697MedicaidMA
351369OtherMAHARVARD PILGRIM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031107000143 MA Practitioner - Chiropractic 7214840156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

249 Central St
Lowell, MA 01852-2214
Phone (978) 452-1466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Corporate Chiropractic, Inc. Chiropractor Past Accepting new patients
New England Health and Wellness LLC PastSince Apr 1, 2012 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1396831053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 CENTRAL ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522214",
            "telephone_number": "978-452-1466",
            "fax_number": "978-452-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 CENTRAL ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522214",
            "telephone_number": "978-452-1466",
            "fax_number": "978-452-1826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 Osgood St",
            "address_purpose": "LOCATION",
            "city": "North Andover",
            "state": "MA",
            "postal_code": "018451501",
            "country_code": "US",
            "telephone_number": "978-557-9355",
            "fax_number": "978-975-2437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "2553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "606350",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "Y36807",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "468952",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "63563",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PR1697",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "351369",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.