Justin Craig Ellerbroek, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

38816 Issued in IA

Practice address

3741 Pheasant LN
Waterloo, IA 50701-5215

Phone

(319) 234-6000

Fax

(319) 234-6001

NPI assigned

Jun 22, 2007

Sex

Male

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 IA

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

Dermatology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Dermatology LTDGroup PAC ID 3173765294, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sartori Memorial Hospital, Inc Hospital, Cedar Falls, IA, CCN 160040
• Allen Hospital Hospital, Waterloo, IA, CCN 160110
• Mercyone Waterloo Medical Center Hospital, Waterloo, IA, CCN 160067

Merit-based Incentive Payment System (MIPS)

Final score

92.87 of 100Reported as group

Quality

93.47

Promoting interoperability

100

Improvement activities

40

Cost

82.77

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Premier Dermatology, LTD.

  • Dermatology Physician
  • Waterloo, IA
  • NPI 1467898007
  Medicare reassignment Care Compare group NPD Authorized official
• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390
  NPD (past)

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

• Allen Memorial Hospital Corporation

  dba Allen Hospital

  • General Acute Care Hospital
  • Waterloo, IA
  • NPI 1336231091
  Care Compare affiliation
• Covenant Medical Center Inc

  dba MercyOne Waterloo Medical Center

  • General Acute Care Hospital
  • Waterloo, IA
  • NPI 1700827896
  Care Compare affiliation
• Sartori Memorial Hospital Inc

  dba MercyOne Cedar Falls Medical Center

  • General Acute Care Hospital
  • Cedar Falls, IA
  • NPI 1942241955
  Care Compare affiliation

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1790981207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2400",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042400",
            "telephone_number": "319-234-6000",
            "fax_number": "319-234-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 PHEASANT LN",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015215",
            "telephone_number": "319-234-6000",
            "fax_number": "319-234-6001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 9th St SW Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "IA",
            "postal_code": "506772909",
            "country_code": "US",
            "telephone_number": "319-234-6000",
            "fax_number": "319-234-6001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLERBROEK",
        "first_name": "JUSTIN",
        "middle_name": "CRAIG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IA",
            "license": "38816",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IA",
            "license": "38816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elitecare Healthservices LLC
• Elitecare Medical Transport LLC
• Elitecare Medical Transportation
• Gabriel Khalil Eljdid, DO
• Alena Davida Ellerbroek, MSN,FNP
• Kent P Ellerbroek, MD
• Kimberly Ellingson, LMHC
• Shanna Ruth Elliott, DO
• Tracy R Elliott, ARNP, MSN
• Elmstead Counseling LLC

• Dermatology Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Dermatology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.