Chad Langston Broome-Webster, MD
Individual provider Active NPI Cardiovascular Disease Physician · Orange City, FL
NPI 1669430732 · NPPES record last updated Dec 7, 2017
Key facts
- NPI
- 1669430732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- ME83626 (FL)
- Practice address
- 938 Saxon Blvd
Suite 101 C
Orange City, FL 32763-8305 - Phone
- (386) 774-5485
- Fax
- (386) 775-0761
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- University of Connecticut School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Halifax Healthcare Systems Inc
Lewis and Klancke Cardiology PA
Florida Hospital Healthcare Partners, Inc
Practice addresses (Care Compare)
3300 E Halifax Crossing Blvd
Deltona, FL 32725-2911
Phone (386) 425-6100
695 N Clyde Morris Blvd
Daytona Heart Group
Daytona Beach, FL 32114-2321
Phone (386) 258-8722
701 W Plymouth Ave
Deland, FL 32720-3236
Phone (386) 943-4522
Hospital & facility affiliations
- Adventhealth Deland
- Adventhealth Fish Memorial
- Halifax Health /Uf Health Medical Center of Delton
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090305000601 | FL | Practitioner - Cardiovascular Disease (Cardiology) |
6204992886 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 83626 | FL | MD | Nuclear Cardiology Physician |
Practice roles (9 of 11)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital-West Volusia Inc | Current |
Accepting new patients | |
| Memorial Hospital-West Volusia Inc | Current |
Accepting new patients | |
| Southwest Volusia Healthcare Corporation | Current | Accepting new patients | |
| Halifax Healthcare Systems Inc | Current |
Accepting new patients | |
| Southwest Volusia Healthcare Corporation | Current |
Accepting new patients | |
| Florida Hospital Healthcare Partners, Inc | Current |
Accepting new patients | |
| Lewis & Klancke Cardiology PA | Cardiovascular Disease | Current |
Accepting new patients |
| Southwest Volusia Healthcare Corporation | Cardiovascular Disease | Current |
Accepting new patients |
| Lewis & Klancke Cardiology PA | Cardiovascular Disease | Past | Accepting new patients |
Locations
695 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 258-8722
303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285
630 W Plymouth Ave
Deland, FL 32720
Phone (386) 734-3654
701 W Plymouth Ave
Deland, FL 32720
Phone (386) 943-3160
3300 E Halifax Crossing Blvd
Deltona, FL 32725
Phone (386) 425-1800
1565 Saxon Blvd
Ste 102
Deltona, FL 32725
Phone (386) 789-5400
938 Saxon Blvd
Ste 101C
Orange City, FL 32763
Phone (386) 774-5485
1035 Town Center Dr
Orange City, FL 32763
Phone (386) 775-8229
1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000
61 Memorial Medical Pkwy
Ste 1-800A
Palm Coast, FL 32164
Phone (386) 586-1810
60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Cardiology Physician | 207UN0901X | ME 83626 | FL | |
| Cardiovascular Disease Physician | 207RC0000X | ME83626 | FL | Yes |
Addresses
Primary practice location
938 Saxon Blvd
Suite 101 C
Orange City, FL 32763-8305
Mailing address
695 N Clyde Morris Blvd
Daytona Beach, FL 32114-2321
Phone (386) 258-8722
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06618 | Other | FL | BCBS |
| 263267500 | Medicaid | FL |
Other providers in Orange City, FL
- Tasha Naomi Brickhouse
- Krista Brinkerhoff
- Thomas J Brodrick
- Alyssa Brooks
- Broome Vision Inc
- Dorna J Broome-Webster
- Joy Prinsell Brothers
- Stephanie Brown
- Nicola Marsha-Ann Bryan-Henderson
- Gerard Kevin Buckley
All providers in Orange City, FL · Cardiovascular Disease Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.