Individual provider Active NPI

Harry L Broome Jr., M.D.

  • Pediatric Adolescent Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1619973880
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
24182 Issued in AZ
Practice address
4700 N 51St Ave
Ste 4
Phoenix, AZ 85031-1237
Phone
(623) 846-7575
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 24182 AZ
Pediatric Adolescent Medicine Physician 2080A0000X 24182 AZ Primary

Addresses

Primary practice location

4700 N 51St Ave
Ste 4
Phoenix, AZ 85031-1237

Mailing address

4700 N 51St Ave
Ste 4
Phoenix, AZ 85031-1237
Phone (623) 846-7575

Other identifiers 5

IdentifierTypeStateIssuer
85031A010OtherAZTRICARE
1399198OtherAZUNITED HEALTHCARE
350893MedicaidAZ
AZ0395370OtherAZBCBS
1Z8750OtherAZHEALTHNET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20120316000689 AZ Practitioner - Pediatric Medicine 1557520103 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24182AZMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jan 15, 2012 Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
North Scottsdale Pediatric Associates Pediatrics Past Accepting new patients

Locations

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

Interoperability endpoints

  • Direct secure messaging: drbroome@mvpkidscare.opdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1619973880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 N 51ST AVE",
            "address_2": "STE 4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311237",
            "telephone_number": "623-846-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N 51ST AVE",
            "address_2": "STE 4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850311237",
            "telephone_number": "623-846-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "HARRY",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "24182",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "AZ",
            "license": "24182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "85031A010",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1399198",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350893",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0395370",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1Z8750",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.