Kimberly Marie Broussard, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.200597 Issued in LA

Practice address

249 Corporate Dr
Houma, LA 70360-2769

Phone

(985) 853-0900

NPI assigned

Apr 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

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

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Seeca Medical IncGroup PAC ID 8022115302, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.29 of 100Reported as group

Quality

54.62

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Seeca Medical Inc

  • Ophthalmology Physician
  • Houma, LA
  • NPI 1851410948
  Medicare reassignment Care Compare group
• LCMC Urgent Care LLC

  • Urgent Care Clinic/Center
  • New Orleans, LA
  • NPI 1184162877
  Medicare reassignment
• St. Francis Urgent Care LLC

  • Urgent Care Clinic/Center
  • Monroe, LA
  • NPI 1194104513
  Medicare reassignment
• Thibodaux Emergency Physicians Group LLC

  • Emergency Medicine Physician
  • Thibodaux, LA
  • NPI 1568910503
  Medicare reassignment
• Total Urgent Care and Occupational Medicine

  • Urgent Care Clinic/Center
  • Cut Off, LA
  • NPI 1760871602
  Medicare reassignment

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1508200577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 CORPORATE DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703602769",
            "telephone_number": "985-853-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 CORPORATE DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703602769",
            "telephone_number": "985-853-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2330438",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01253212",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broadmoor Drug Center Inc
• Richard L Brooke, MD
• Sarah Larke Brooke, LCSW
• Dejae Antrell Broomfield
• Alison Ann Broussard
• Nina Claire Broussard, NP
• Anh Brown
• Ashanta Brown
• Ashley Da'Nae Brown
• Bienelyn Brown, M.A.

• Physician Assistant in Houma, LA
• Providers in Houma, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.