John Phillippe Broadnax, M.D.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

036124156 Issued in IL

Practice address

1880 W Winchester Rd Ste 101
Libertyville, IL 60048-5321

Phone

(847) 281-9543

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Pain ManagementAlso: Anesthesiology

Education

Johns Hopkins University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Institute of America PLLCGroup PAC ID 8426337031, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dallas Regional Medical Center Hospital, Mesquite, TX, CCN 450688

Merit-based Incentive Payment System (MIPS)

Final score

91.79 of 100Reported as individual

Quality

100

Improvement activities

40

Cost

72.65

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DJBICD/Endpoint/DJBICD
• Direct secure messaging: jbroadnax676484@direct.sw.org
• FHIR API: https://fhir4.healow.com/fhir/r4/DJBICD
• Direct secure messaging: jbroadnax1743464@direct.texashealth.org

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.

• Pain Institute of America, PLLC

  • Specialist
  • Lewisville, TX
  • NPI 1750839866

  TX

  Medicare reassignment Care Compare group NPD
• Sonax Anesthesia PLLC

  • Anesthesiology Physician
  • Plano, TX
  • NPI 1750889010

  Anesthesiology, TX

  Medicare reassignment NPD
• Texas Anesthesia Partners, PLLC

  • Anesthesiology Physician
  • Southlake, TX
  • NPI 1144673468

  Anesthesiology, TX

  Medicare reassignment NPD
• Vericon Anesthesia PLLC

  • Anesthesiology Physician
  • Plano, TX
  • NPI 1598302945

  Anesthesiology, TX

  Medicare reassignment NPD
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Greater Texas Anesthesia Consultants PLLC

  • Anesthesiology Physician
  • Plano, TX
  • NPI 1588201073

  Anesthesiology

  NPD (past)

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

• Prime Healthcare Services Mesquite LLC

  • General Acute Care Hospital
  • Mesquite, TX
  • NPI 1790174860

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1457409104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S MERCER AVE",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 W WINCHESTER RD STE 101",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485321",
            "telephone_number": "847-281-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADNAX",
        "first_name": "JOHN",
        "middle_name": "PHILLIPPE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "225876",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036124156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Brennan, ED.S, LCPC
• Patricia Bress, SLP
• Brian P Danielewicz DDS LTD
• Anastasia Brierton, DO
• Brightlife Regenerative Medical Clinic SC
• Broadreach Counseling LLC
• Richard N. Brochu, DDS
• Christianna Broton, SLP
• Browdy Home Care, Inc.
• Frettina Brown, MS,LPC,NCC

• All providers in Libertyville, IL
• Pain Medicine (Anesthesiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.