Individual provider Active NPI

Emily Brienne Broder, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1649165945
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
2770 Broadway
New York, NY 10025-2811
Phone
(121) 267-8053
NPI assigned
Jun 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0 NY Primary

Addresses

Primary practice location

2770 Broadway
New York, NY 10025-2811

Mailing address

66 Commonwealth Dr
Glenmont, NY 12077-3214
Phone (518) 506-2157

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2579 31St St
Apt 6a
Astoria, NY 11102-1748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1649165945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 COMMONWEALTH DR",
            "city": "GLENMONT",
            "state": "NY",
            "postal_code": "120773214",
            "telephone_number": "518-506-2157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252811",
            "telephone_number": "121-267-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODER",
        "first_name": "EMILY",
        "middle_name": "BRIENNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.