NPIMap

Individual provider Active NPI

Jonathan D Broder, M.D.

  • Diagnostic Radiology Physician
  • Rochester, NY
National Provider Identifier
1477522514
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
216942 Issued in NY
Practice address
1425 Portland Ave
Rochester, NY 14621-3001
Phone
(585) 922-3220
Fax
(585) 922-3518
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 216942 NY Primary
Vascular & Interventional Radiology Physician 2085R0204X 216942 NY

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621-3001

Mailing address

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-3220

Other identifiers 1

IdentifierTypeStateIssuer
02057129MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101014000758 NY Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 9537056924 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians
Western New York Medical Practice PCGroup PAC ID 3870767791, 528 clinicians
United Memorial Medical CenterGroup PAC ID 0547259376, 271 clinicians
The Unity Hospital of RochesterGroup PAC ID 9436060969, 732 clinicians
Clifton Springs Sanitarium CoGroup PAC ID 5092704809, 230 clinicians

Practice addresses (Care Compare)

10 Hagen Dr
Suite 10
Rochester, NY 14625-2662
Phone (585) 267-8200

100 Cross Keys Office Park
Suite 170
Fairport, NY 14450-3509
Phone (585) 223-1945

1208 Driving Park Ave
Newark, NY 14513-1057
Phone (315) 359-2640

1250 Driving Park Ave
Newark, NY 14513-1057
Phone (315) 332-2427

1255 Portland Ave
Rochester, NY 14621-2713
Phone (585) 336-5000

127 N St
Batavia, NY 14020-1631
Phone (585) 344-5449

1415 Portland Ave
Rochester, NY 14621-3038
Phone (585) 922-0390

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

1455 E Ridge Rd
Rochester, NY 14621-2006
Phone (585) 922-5033

1555 Long Pond Rd
Rochester, NY 14626-4122
Phone (585) 723-7205

2 Coulter Rd
Clifton Springs, NY 14432-1122
Phone (315) 462-5711

2000 Empire Blvd
Webster, NY 14580-1957

214 Alexander St
Suite 1000
Rochester, NY 14607-4002
Phone (585) 922-7900

220 Alexander St
Suite 708
Rochester, NY 14607-4002
Phone (585) 922-8003

224 Alexander St
Suite 200
Rochester, NY 14607-4002
Phone (585) 922-8400

360 Linden Oaks
Rochester, NY 14625-2814
Phone (585) 922-7272

4302 Gateway Dr
Geneseo, NY 14454-9449
Phone (585) 922-1000

833 Canandaigua Rd
Geneva, NY 14456-2015
Phone (315) 210-1337

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125
  • Newark-Wayne Community Hospital Hospital, Newark, NY, CCN 330030
  • Unity Hospital Hospital, Rochester, NY, CCN 330226
  • United Memorial Medical Center Hospital, Batavia, NY, CCN 330073

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Memorial Medical Center Current Accepting new patients
Clifton Springs Sanitarium Co CurrentSince Oct 22, 2025 Accepting new patients
Rochester General Hospital Current Accepting new patients
Rochester General Hospital CurrentSince Jan 1, 2013 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Western New York Medical Practice P.C. CurrentSince Jan 1, 2013 Accepting new patients
United Memorial Medical Center CurrentSince Jun 1, 2022 Accepting new patients
The Unity Hospital of Rochester CurrentSince Sep 16, 2019 Accepting new patients

Locations

229 Summit St
Ste 1
Batavia, NY 14020
Phone (585) 343-4440

127 North St
Batavia, NY 14020
Phone (585) 267-7510

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

1415 Portland Ave
Ste 100
Rochester, NY 14621
Phone (585) 266-1000

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

Organizations & group practices 8

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.

Hospital & facility affiliations 12

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1477522514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-3220",
            "fax_number": "585-922-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-3220",
            "fax_number": "585-922-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODER",
        "first_name": "JONATHAN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "216942",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NY",
            "license": "216942",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02057129",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.