Individual provider Active NPI

Timothy J Broach, MD

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1508822792
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01061214A Issued in IN
Practice address
550 University Blvd # Uh3005
Indianapolis, IN 46202-5149
Phone
(317) 962-8851
Fax
(317) 962-5957
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 01061214A IN
Internal Medicine Physician 207R00000X 01061214A IN Primary

Addresses

Primary practice location

550 University Blvd # Uh3005
Indianapolis, IN 46202-5149

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other practice location 2

1800 N Capitol Ave
NP E 140
Indianapolis, IN 46202-1218
Phone (317) 962-2894

Other identifiers 4

IdentifierTypeStateIssuer
000001000789OtherINANTHEM PTAN
1102213746OtherINANTHEM PTAN
200534140MedicaidIN
000000668309OtherINANTHEM PTAN

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address tbroach@direct.iuhealth.org
Direct Messaging Address tbroach@direct.iuhealth.org Direct
Direct Messaging Address tbroach@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20051115001083 IN Practitioner - Hospice/Palliative CarePractitioner - Internal Medicine 5092734442 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Dec 1, 2022 Accepting new patients
University Family Physicians, Inc. Internal Medicine CurrentSince Dec 1, 2022 Accepting new patients
Indiana Clinic Critical Care LLC Internal Medicine CurrentSince Feb 15, 2010 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Respiratory & Critical Care Consultants P C Internal Medicine Past Accepting new patients
University Medical Diagnostic Associates, Inc. Internal Medicine Past Accepting new patients

Locations

7216 Solutions Ctr
Chicago, IL 60677

2574 Reliable Pkwy
Chicago, IL 60686

13500 N Meridian St
Carmel, IN 46032
Phone (317) 573-7000

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

550 University Blvd
#3005
Indianapolis, IN 46202
Phone (317) 944-2167

1002 Wishard Blvd
Fl 4
Indianapolis, IN 46202
Phone (317) 692-2323

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

1800 N Capitol Ave
#140
Indianapolis, IN 46202
Phone (317) 962-2894

1801 Senate Blvd
Ste 230
Indianapolis, IN 46202
Phone (317) 962-5280

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

5515 W 38th St
Indianapolis, IN 46254
Phone (317) 880-3838

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

720 Eskenazi Ave
Fl 5
Indianapolis, IN 46202
Phone (317) 880-6000

1000 S Main St
Tipton, IN 46072
Phone (765) 675-8500

Interoperability endpoints

  • Direct secure messaging: tbroach@direct.iuhealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Indiana University Health HospiceIndianapolis, IN, CCN 151511 Hospice W-2 Managing Employee Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1508822792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD # UH3005",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-962-8851",
            "fax_number": "317-962-5957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 N Capitol Ave",
            "address_2": "NP E 140",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021218",
            "country_code": "US",
            "telephone_number": "317-962-2894",
            "fax_number": "317-963-5285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROACH",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "IN",
            "license": "01061214A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01061214A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000001000789",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1102213746",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200534140",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "000000668309",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbroach@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "1800 N Capitol Ave",
            "address_2": "NP E 140",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbroach@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 University Blvd # Uh3005",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbroach@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.