Kristy Rose Broderick, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

19601 Issued in CA

Practice address

200 W Arbor Dr Dept 8220
San Diego, CA 92103-8220

Phone

(619) 840-4432

NPI assigned

Aug 27, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristy Rose Abdou Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of CaliforniaGroup PAC ID 3577476761, shared by 18 NPIs, 2,047 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025

Merit-based Incentive Payment System (MIPS)

Final score

90.77 of 100Reported as group

Quality

84.13

Promoting interoperability

100

Improvement activities

40

Cost

73.88

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Regents of the University of California

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • San Diego, CA
  • NPI 1235232778
  Medicare reassignment NPD
• Regents of the University of California

  • Plastic Surgery Physician
  • San Diego, CA
  • NPI 1326141862
  Medicare reassignment NPD
• Regents of the University of California

  • Surgery Physician
  • San Diego, CA
  • NPI 1740382993
  Medicare reassignment NPD
• Regents of the University of California

  • Clinical Neurophysiology Physician
  • San Diego, CA
  • NPI 1881796811
  Medicare reassignment NPD
• Regents of the University of California

  • Diagnostic Radiology Physician
  • San Diego, CA
  • NPI 1558463927
  NPD
• Regents of the University of California

  • Neurological Surgery Physician
  • San Diego, CA
  • NPI 1760594998
  NPD
• Regents of the University of California

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• Regents of the University of California Ucsd Head and Neck Surgery

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1679509962
  NPD (past)

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

• Regents of the University of California

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1184722779
  Care Compare affiliation

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1487801817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR DEPT 8220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038220",
            "telephone_number": "619-929-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR DEPT 8220",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921038220",
            "telephone_number": "619-840-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "KRISTY",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200441107RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "19601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "ABDOU",
            "middle_name": "ROSE",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danika Brodak, M.D.
• Kevin Wayne Broder, MD
• Pamela Anne Broder, PHARM.D.
• Chasmal Tyesha Broderick
• David L. Broderick Jr., B.A.
• Lori Broderick, M.D., PH.D.
• Ryan C Broderick, M.D
• James Sean Brodfuehrer, DDS
• Fred Joseph Brodie, DIVE IDC
• Michelle Marie Brodie, MS

• Family Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.