Individual provider Active NPI

Todd Broder, M.D.

  • Psychiatry Physician
  • St Augustine, FL
National Provider Identifier
1699849349
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME97336 Issued in FL
Practice address
400 Health Park Blvd
St Augustine, FL 32086-5784
Phone
(904) 819-5155
NPI assigned
Nov 17, 2006
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME97336 FL Primary
Forensic Psychiatry Physician 2084F0202X ME97336 FL

Addresses

Primary practice location

400 Health Park Blvd
St Augustine, FL 32086-5784

Mailing address

PO Box 103424
Gainesville, FL 32610-3424
Phone (352) 265-7981

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 392-8013

Other practice location 2

600 E Dixie Ave
Leesburg, FL 34748-5925
Phone (352) 265-7981

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100716000820 FL Practitioner - Psychiatry 3375675978 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Florida College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Villages Regional Hospital Physician Services LLCGroup PAC ID 0244688893, 198 clinicians
Balance Psychiatry and Wellness LLCGroup PAC ID 7618416074, 2 clinicians

Practice addresses (Care Compare)

10435 SE 170TH PL
Summerfield, FL 34491-8998
Phone (352) 255-3615

142 E Gore St
Orlando, FL 32806-1223
Phone (307) 388-0400

400 Health Park Blvd
St Augustine, FL 32086-5784
Phone (904) 823-1447

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME97336FLMDForensic Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Psychiatry and Wellness LLC Psychiatry CurrentSince Aug 2, 2024 Accepting new patients
Flagler Hospital Inc CurrentSince May 7, 2016 Accepting new patients
Florida Center for TMS Psychiatry CurrentSince Jan 1, 2019 Accepting new patients
Villages Regional Hospital Physician Services LLC CurrentSince Apr 1, 2025 Accepting new patients
Flagler Hospital CurrentSince May 7, 2016 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

600 E Dixie Ave
Leesburg, FL 34748
Phone (352) 323-5090

17 Saint Johns Medical Park Dr
St Augustine, FL 32086
Phone (904) 429-7076

201 Health Park Blvd
Ste 212
St Augustine, FL 32086
Phone (904) 819-4040

400 Health Park Blvd
St Augustine, FL 32086
Phone (904) 819-4300

10435 SE 170th Pl
Summerfield, FL 34491
Phone (352) 245-7788

Interoperability endpoints

  • Direct secure messaging: drtoddbroder@balancepw.medentdirect.com
  • Direct secure messaging: tbroder180477@direct.shands.ufl.edu

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1699849349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 103424",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103424",
            "telephone_number": "352-265-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865784",
            "telephone_number": "904-819-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-392-8013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 E Dixie Ave",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347485925",
            "country_code": "US",
            "telephone_number": "352-265-7981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODER",
        "first_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME97336",
            "primary": true
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "FL",
            "license": "ME97336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.