Individual provider Active NPI

Justin Neal Brohard, DO

  • Orthopaedic Foot and Ankle Surgery Physician
  • Salem, OR
National Provider Identifier
1588012900
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X
License
DO193144 Issued in OR
Practice address
1600 State St
Salem, OR 97301-4257
Phone
(503) 540-6300
Fax
(503) 540-6404
NPI assigned
May 26, 2016
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Foot and Ankle Surgery Physician 207XX0004X DO193144 OR Primary

Addresses

Primary practice location

1600 State St
Salem, OR 97301-4257

Mailing address

1600 State St
Salem, OR 97301-4257
Phone (503) 540-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20220817003537 OR Practitioner - Orthopedic Surgery 2769776947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

1600 State St
Salem, OR 97301-4257
Phone (503) 561-5200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO193144ORMDOrthopaedic Foot and Ankle Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health Orthopaedic Surgery Current Accepting new patients
Salem Health Orthopaedic Surgery CurrentSince Sep 29, 2023 Accepting new patients
Salem Health CurrentSince Sep 29, 2023 Accepting new patients

Locations

5825 Shoreview Ln N
Keizer, OR 97303
Phone (503) 540-6471

1600 State St
Salem, OR 97301
Phone (503) 540-6472

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

Interoperability endpoints

  • Direct secure messaging: jbrohard128311@samhealth.direct-ci.com
  • Direct secure messaging: jbrohard341123@direct.salemhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1464220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1588012900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014257",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 STATE ST",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014257",
            "telephone_number": "503-540-6300",
            "fax_number": "503-540-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROHARD",
        "first_name": "JUSTIN",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-26",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": "OR",
            "license": "DO193144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.