Eric S. Broadway, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

16956 Issued in OK

Practice address

1505 E Main St
Stigler, OK 74462-2913

Phone

(918) 967-3368

Fax

(918) 967-4582

NPI assigned

Oct 4, 2006

Last updated

Nov 17, 2009By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in OK

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

Psychiatry

Education

University of Oklahoma College of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stigler Health and Wellness Center IncGroup PAC ID 8022061373, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ebroadway728012@direct.ochin.org

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.

• Stigler Health and Wellness Center Inc

  • Federally Qualified Health Center (FQHC)
  • Stigler, OK
  • NPI 1891752853
  Medicare reassignment Care Compare group NPD
• McAlester Medical Services, LLC

  • Internal Medicine Physician
  • McAlester, OK
  • NPI 1154317998
  NPD (past)
• Stigler Health and Wellness Center Inc

  dba The Pines

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Poteau, OK
  • NPI 1558015800
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1790870905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744620179",
            "telephone_number": "918-967-4560",
            "fax_number": "918-967-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 E MAIN ST",
            "city": "STIGLER",
            "state": "OK",
            "postal_code": "744622913",
            "telephone_number": "918-967-3368",
            "fax_number": "918-967-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWAY",
        "first_name": "ERIC",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OK",
            "license": "16956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "16956",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100119810A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra L Borne Tustin, LPC
• Kenneth John Boyd
• Shannon Jo Boyd
• Bradley E Brewer
• Dalena Brewer
• Anita Busby
• Alysha Buselt
• Joshua Michael Buselt
• Kensie Bush, APRN-CNP
• Patricia G Bush, MSN RN AGPCNP

• Psychiatry Physician in Stigler, OK
• Providers in Stigler, OK by specialty
• Psychiatry Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.