Tina Esther G Bronner, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M-12726 Issued in ID

Practice address

500 W Fort St
Boise, ID 83702-4501

Phone

(208) 422-1000

NPI assigned

Apr 3, 2006

Last updated

Feb 9, 2023By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1760444244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 W ADA ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023450",
            "telephone_number": "619-384-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W FORT ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024501",
            "telephone_number": "208-422-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 W Ada St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837023450",
            "country_code": "US",
            "telephone_number": "619-384-4086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRONNER",
        "first_name": "TINA ESTHER",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A90271",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-12726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel J Broderick, DO
• Melva June Broderick, R.N.
• Thomas W Broderick, M.D.
• Bronco Senior Services (Hillcrest)
• Jason Bronner, MD
• Brookdale Dental, PA
• Brookdale Senior Living Communities, Inc. (Brookdale Boise Parkcenter)
• Allison Brookins, MPT
• Abbie L Brooks, FNP-C
• Daniel R Brooks, MD

• Internal Medicine Physician in Boise, ID
• Providers in Boise, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.