Daniel James Broussard, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

OA004910 Issued in PA

Practice address

727 Welsh Rd Ste 103
Huntingdon Valley, PA 19006-6357

Phone

(215) 947-7550

Fax

(215) 947-0590

NPI assigned

Jun 8, 2018

Last updated

Oct 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Aria Health OrthopaedicsGroup PAC ID 2365695251, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Health- Northeast Hospital, Philadelphia, PA, CCN 390115

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Aria Health Orthopaedics

  • Orthopaedic Surgery Physician
  • Langhorne, PA
  • NPI 1376895342
  Medicare reassignment Care Compare group
• Aria Health Physician Services

  dba Richboro Medical

  • Family Medicine Physician
  • Richboro, PA
  • NPI 1750949806
  Medicare reassignment Care Compare group
• Pinnacle Physicians Group LLC

  • Family Medicine Physician
  • Trevose, PA
  • NPI 1184984809
  Medicare reassignment
• Aria Health Physician Services

  dba Geoffrey W. Temple Family Medical Associates

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053181297
  NPD
• Aria Health Physician Services

  dba Aria Allmed Urgent Care Center Street Road

  • Surgery Physician
  • Bensalem, PA
  • NPI 1437537792
  NPD
• Aria Health Physician Services

  dba Aria Health Physician Services - Bucks Surgery

  • Surgery Physician
  • Langhorne, PA
  • NPI 1114981123
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jefferson Health - Northeast

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1801963343
  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1679066211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 WELSH RD STE 103",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066357",
            "telephone_number": "215-947-7550",
            "fax_number": "215-947-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 WELSH RD STE 103",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066357",
            "telephone_number": "215-947-7550",
            "fax_number": "215-947-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-08",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "OA004910",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA004910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bright Start Therapy Inc.
• Maureen Catherine Broderick, LPC
• Karen Lisa Brog, SLP
• Marc Brog
• Brotherly Love Home Care
• Bruce S Morrison DO PC
• Christine Ka Bruce, M.DIV., MCAT, LMFT
• Laura J. Bruch, LCSW
• Leonard A Bruno, M.D.
• Bucks Family Therapy Center LLC

• Physician Assistant in Huntingdon Valley, PA
• Providers in Huntingdon Valley, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.