Active NPI
William George Broadhurst, PAC
- Physician Assistant
- Brookfield, CT
National Provider Identifier
1740277797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001092
- Practice address
- 60 Old New Milford Rd
Suite 3E
Brookfield, CT 06804-2430 - Phone
- (203) 775-6205
- Fax
- (203) 775-2414
- NPI assigned
- Oct 4, 2005
- Last updated
- Oct 28, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001092 | CT | Primary |
Addresses
Primary practice location
60 Old New Milford Rd
Suite 3E
Brookfield, CT 06804-2430
Mailing address
60 Old New Milford Rd
Suite 3E
Brookfield, CT 06804-2430
Phone (203) 775-6205
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P2679140 | Other | CT | OXFORD |
| 2V5849 | Other | CT | HEALTHNET |
| 290001092CT05 | Other | CT | BLUE CROSS BLUE SHIELD |
| 109200 | Other | CT | CONNECTICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118
34 Maple St
Norwalk, CT 06850-3815
Phone (203) 762-5588
6 Greenwich Office Park
Greenwich, CT 06831-5151
Phone (203) 869-1145
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic & Neurosurgery Specialists, PLLC | Physician Assistant | Current | Accepting new patients |
| Orthopaedic & Neurosurgery Specialists, PLLC | Current | Accepting new patients | |
| Orthoconnecticut, PLLC | Past | Accepting new patients |
Locations
6 Greenwich Office Park
Greenwich, CT 06831
Phone (203) 869-1145
249 Danbury Rd
Wilton, CT 06897
Phone (203) 762-3353
Organizations & group practices 4
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.
-
- Orthopaedic Surgery Physician
- Greenwich, CT
- NPI 1033318720
Physician Assistant
-
- Internal Medicine Physician
- Danbury, CT
- NPI 1407898117
-
- Orthopaedic Surgery Physician
- Newington, CT
- NPI 1043086531
-
- Orthopaedic Surgery Physician
- Danbury, CT
- NPI 1770507345
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Norwalk, CT
- NPI 1346441953
-
- General Acute Care Hospital
- Norwalk, CT
- NPI 1427041581
-
- General Acute Care Hospital
- Norwalk, CT
- NPI 1649263880
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288224000000",
"number": "1740277797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 OLD NEW MILFORD RD",
"address_2": "SUITE 3E",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068042430",
"telephone_number": "203-775-6205",
"fax_number": "203-775-2414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 OLD NEW MILFORD RD",
"address_2": "SUITE 3E",
"city": "BROOKFIELD",
"state": "CT",
"postal_code": "068042430",
"telephone_number": "203-775-6205",
"fax_number": "203-775-2414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADHURST",
"first_name": "WILLIAM",
"middle_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-04",
"last_updated": "2010-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "001092",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P2679140",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "2V5849",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "290001092CT05",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "109200",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.