Anders Elle Broussard, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

25697 Issued in MA

Practice address

386 W Broadway
South Boston, MA 02127-2215

Phone

(617) 752-4672

NPI assigned

Aug 23, 2021

Last updated

Aug 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bay State Physical Therapy of Randolph Inc

  dba Milton Chiropractic and Rehabilitation INC

  • Chiropractor
  • Quincy, MA
  • NPI 1316507627
  NPD
• Outback Physical Therapy, Inc.

  dba Outback Physical Therapy

  • Physical Therapy Clinic/Center
  • Somerville, MA
  • NPI 1114272515
  NPD

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

{
    "created_epoch": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1750057360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 GRANITE ST STE 3",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845350",
            "telephone_number": "781-807-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 W BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272215",
            "telephone_number": "617-752-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "ANDERS",
        "middle_name": "ELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "25697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Boston Medical Center Corporation (BMC Pharmacy at South Boston)
• Boston Public Health Commission (Behavioral Health Services)
• Rosemary Bowman, LICSW
• Kerriann M Breland, LCSW
• Madeline F Brisotti
• Isabella Buzzo Bellon Brout, MD
• Paul Brown, LICSW
• Patricia O'Hara Brunner V, SLP
• Jessica Butler
• Kathleen Cahill

• Physical Therapist in South Boston, MA
• Providers in South Boston, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.