Louis T Broad, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD016957E Issued in PA

Practice address

1101 Chestnut St
Philadelphia, PA 19107-3612

Phone

(215) 955-8900

Fax

(215) 955-5245

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

Jefferson Medical College of Thomas Jefferson University, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jefferson University Physicians 1,528 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675

  PA

  Medicare reassignment Care Compare group NPD
• Broad & Joseph Associates

  • Gastroenterology Physician
  • Phila, PA
  • NPI 1871691212

  Gastroenterology

  NPD (past) Authorized official
• Jefferson University Physicians

  • Dermatology Physician
  • Greenville, DE
  • NPI 1295011419
  Care Compare group
• Jefferson University Physicians

  • Gastroenterology Physician
  • Phila, PA
  • NPI 1205898723

  Gastroenterology

  NPD (past)

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

• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1710085147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST",
            "address_2": "480 MAIN BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075244",
            "telephone_number": "215-955-8900",
            "fax_number": "215-955-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CHESTNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073612",
            "telephone_number": "215-955-8900",
            "fax_number": "215-955-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROAD",
        "first_name": "LOUIS",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD016957E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0059855001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Broad Street Chiropractic & Wellness Center, LLC
• Broad Street Family Pharmacy
• Broad Street Medical LLC
• Broad Street Professional Medical Services LLC
• Broad Wellness and Chiropractic Center, P.C.
• Michael Broadbent, COTA/L
• Ida Elise Broadwater, CRNP
• Doriean Broady, DPT
• Rachel Emily Brobst, DO
• Monica Brocco, MD

• All providers in Philadelphia, PA
• Gastroenterology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.