Individual provider Active NPI

William E. Brodkin, M.D.

  • Internal Medicine Physician
  • Leominster, MA
National Provider Identifier
1457468670
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36624 Issued in MA
Practice address
50 Memorial Dr
Suite 208
Leominster, MA 01453-2238
Phone
(978) 537-6639
Fax
(978) 537-8680
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36624 MA Primary

Addresses

Primary practice location

50 Memorial Dr
Suite 208
Leominster, MA 01453-2238

Mailing address

50 Memorial Dr
Suite 208
Leominster, MA 01453-2238
Phone (978) 537-6639

Other identifiers 1

IdentifierTypeStateIssuer
2016494MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050825000815 MA Practitioner - Internal Medicine 1052342490 Practice locations: Leominster, MA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

50 Memorial Dr
Suite 208
Leominster, MA 01453-2238
Phone (978) 537-6639

Hospital & facility affiliations

  • Vna Care Network Home health agency, Worcester, MA, CCN 227098
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001
  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

National Provider Directory

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

Hospital & facility affiliations 4

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457468670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DR",
            "address_2": "SUITE 208",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532238",
            "telephone_number": "978-537-6639",
            "fax_number": "978-537-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DR",
            "address_2": "SUITE 208",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532238",
            "telephone_number": "978-537-6639",
            "fax_number": "978-537-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODKIN",
        "first_name": "WILLIAM",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "36624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016494",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.