Individual provider Active NPI

Deborah Broadhurst

  • General Acute Care Hospital
  • Cambridge, MA
National Provider Identifier
1689051583
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
2898 Issued in MA
Practice address
330 Mount Auburn St
Cambridge, MA 02138-5502
Phone
(617) 673-1712
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 2898 MA Primary

Addresses

Primary practice location

330 Mount Auburn St
Cambridge, MA 02138-5502

Mailing address

330 Mount Auburn St
Cambridge, MA 02138-5502
Phone (617) 673-1712

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmdprod.craneware.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Craneware, Inc.
CONNECT URL https://esmdprod.craneware.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Craneware, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2898MAMDGeneral Acute Care Hospital

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1689051583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-673-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-673-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADHURST",
        "first_name": "DEBORAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MA",
            "license": "2898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmdprod.craneware.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.17.9.1",
            "affiliationName": "Craneware, Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3340 Peachtree Rd NE Ste 850",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303261072",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmdprod.craneware.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.17.9.1",
            "affiliationName": "Craneware, Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "3340 Peachtree Rd NE Ste 850",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303261072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.