Individual provider Active NPI

Michael Norman Brodeur, M.D.

  • Emergency Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1417290180
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q0879 Issued in TX
Practice address
2606 Hospital Blvd
5 West
Corpus Christi, TX 78405-1804
Phone
(361) 902-6570
NPI assigned
Apr 1, 2013
Last updated
May 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X Q0879 TX Primary

Addresses

Primary practice location

2606 Hospital Blvd
5 West
Corpus Christi, TX 78405-1804

Mailing address

2606 Hospital Blvd
5 West
Corpus Christi, TX 78405-1804
Phone (361) 902-6570

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150909000829 TX Practitioner - Emergency Medicine 5496061376 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Coast Emergency Physicians, PLLCGroup PAC ID 6204280480, 108 clinicians

Practice addresses (Care Compare)

1311 E Gen Cvazos Blvd
Kingsville, TX 78363-7150
Phone (361) 595-1661

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q0879TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conner Emergency Medicine Associates, PA Emergency Medicine CurrentSince Feb 15, 2018 Accepting new patients
Nueces Emergency Medicine Associates PA Emergency Medicine CurrentSince Aug 7, 2016 Accepting new patients
Gulf Coast Emergency Physicians, PLLC Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Fastpass Ucdfw, PLLC Past Accepting new patients

Locations

2500 E Main St
Alice, TX 78332
Phone (361) 664-4376

2606 Hospital Blvd
Corpus Christi, TX 78405
Phone (361) 902-4151

2606 Hospital Blvd
#5W
Corpus Christi, TX 78405
Phone (361) 902-6570

3533 S Alameda St
Corpus Christi, TX 78411
Phone (361) 694-5445

600 Elizabeth St
Corpus Christi, TX 78404
Phone (361) 325-2511

1311 Gen Cvazos Blvd
Kingsville, TX 78363
Phone (361) 595-1661

Organizations & group practices 4

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 1

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": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1417290180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 HOSPITAL BLVD",
            "address_2": "5 WEST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051804",
            "telephone_number": "361-902-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 HOSPITAL BLVD",
            "address_2": "5 WEST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051804",
            "telephone_number": "361-902-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODEUR",
        "first_name": "MICHAEL",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-01",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q0879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.