Individual provider Active NPI

Dennis Bruce McBroom Jr., D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Daytona Beach, FL
National Provider Identifier
1689865453
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO 3283 Issued in FL
Practice address
1890 Lpga Blvd Ste 250
Daytona Beach, FL 32117-7131
Phone
(386) 339-4065
NPI assigned
Aug 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO 3283 FL Primary

Addresses

Primary practice location

1890 Lpga Blvd Ste 250
Daytona Beach, FL 32117-7131

Mailing address

1890 Lpga Blvd Ste 250
Daytona Beach, FL 32117-7131
Phone (386) 339-4065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080710000794 FL Practitioner - Podiatry 2163594946 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Pascarella Hoover Finkelstein and Wagner DPM PAGroup PAC ID 9436235645, 102 clinicians
Upperline Healthcare PCGroup PAC ID 4385900653, 194 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1890 Lpga Blvd
Suite 250
Daytona Beach, FL 32117-7131
Phone (386) 832-0703

790 Dunlawton Ave
Suite C
Port Orange, FL 32127-4222
Phone (386) 788-6333

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue40
Removal of skin lesions21
Removal of nail tissue415
Removal or shaving of skin growth128
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO 3283FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Podiatry Associates DPM PA Foot & Ankle Surgery CurrentSince Jul 7, 2008 Accepting new patients
Upperline Healthcare, PC Foot & Ankle Surgery CurrentSince Feb 15, 2021 Accepting new patients
Upperline Healthcare, PC Foot & Ankle Surgery CurrentSince Feb 15, 2021 Accepting new patients
Pascarella Hoover Finkelstein & Wagner DPM PA Foot & Ankle Surgery CurrentSince Jan 15, 2025 Accepting new patients
Pascarella, Hoover, Finkelstein, Wagner, DPM, PA CurrentSince Jan 15, 2025 Accepting new patients

Locations

661 E Altamonte Dr
Ste 210
Altamonte Springs, FL 32701
Phone (407) 339-7759

1890 Lpga Blvd
Ste 250
Daytona Beach, FL 32117
Phone (386) 274-0250

1890 Lpga Blvd
Ste 230
Daytona Beach, FL 32117
Phone (386) 274-3336

819 E Oak St
Ste B
Kissimmee, FL 34744
Phone (407) 846-1234

7350 Sandlake Commons Blvd
Ste 3329
Orlando, FL 32819
Phone (407) 345-5211

21 Hospital Dr
Ste 170
Palm Coast, FL 32164
Phone (386) 586-2280

790 Dunlawton Ave
Ste C
Port Orange, FL 32127
Phone (386) 788-6333

102 Woodmont Blvd
Ste 450
Nashville, TN 37205

Interoperability endpoints

  • Direct secure messaging: dennis.mcbroom.1@4399.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1689865453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD STE 250",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177131",
            "telephone_number": "386-339-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD STE 250",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177131",
            "telephone_number": "386-339-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBROOM",
        "first_name": "DENNIS",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-07",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 3283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.