Jill Diane Broffman, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A49398 Issued in CA

Practice address

150 N Robertson Blvd
Suite 222
Beverly Hills, CA 90211-2142

Phone

(310) 652-4900

Fax

(310) 652-4902

NPI assigned

Jul 10, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 1, 2017 through Nov 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609800630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N ROBERTSON BLVD",
            "address_2": "SUITE 222",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112142",
            "telephone_number": "310-652-4900",
            "fax_number": "310-652-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N ROBERTSON BLVD",
            "address_2": "SUITE 222",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112142",
            "telephone_number": "310-652-4900",
            "fax_number": "310-652-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROFFMAN",
        "first_name": "JILL",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A49398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PPIN #",
            "identifier": "00A493980",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barry J Brock, M.D.
• Lawrence Arthur Brockman, D.M.D.
• Donna Rattner Broder, M.A.
• Michael Broder, MD
• Rachel Brodsky, PA-C
• Dafna Brook, PHD
• Danielle Fagan Brooks, MA, MFT
• H Leon Brooks, MD
• Ivan Israel Brooks, M.D.
• Nicole Brooks, MFT

• Internal Medicine Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.