Jonathan Thomas Broadwell, MD

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

4301505464 Issued in MI

Practice address

3201 Hallmark CT
Saginaw, MI 48603-2109

Phone

(989) 746-7500

NPI assigned

Jun 11, 2019

Last updated

Jun 19, 2024By 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

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 Utah School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of Michigan Office of Financial ManagementGroup PAC ID 5496650723, 22 clinicians

Healthsource Saginaw IncGroup PAC ID 2961475876, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Covenant Medical Center Hospital, Saginaw, MI, CCN 230070

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/saginaw-e4d72067

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.

• Healthsource Saginaw Inc

  • Skilled Nursing Facility
  • Saginaw, MI
  • NPI 1265426704
  Medicare reassignment Care Compare group NPD
• State of Michigan Office of Financial Management

  dba State of Michigan

  • Psychiatric Hospital
  • Westland, MI
  • NPI 1508883299
  Medicare reassignment Care Compare group NPD
• Saginaw Cooperative Hospitals, Inc

  dba Cmu Medical Education Partners

  • Internal Medicine Physician
  • Saginaw, MI
  • NPI 1346344991
  Medicare reassignment NPD
• Whole Mind PLLC

  • Psychiatry Physician
  • Mt Pleasant, MI
  • NPI 1922998335
  Medicare reassignment
• Saginaw Cooperative Hospital Inc

  • Hospitalist Physician
  • Saginaw, MI
  • NPI 1548877434
  NPD
• Saginaw Cooperative Hospitals, Inc

  dba Cmu Medical Education Partners

  • Psychiatry Physician
  • Saginaw, MI
  • NPI 1104106962
  NPD
• State of Michigan Office of Financial Management

  dba Michigan Veteran Homes at Chesterfield Twp

  • Skilled Nursing Facility
  • Chesterfield, MI
  • NPI 1497342653
  NPD
• State of Michigan Office of Financial Management

  dba Caro Psychiatric Hospital

  • Psychiatric Hospital
  • Caro, MI
  • NPI 1194767996
  NPD (past)

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

• Covenant Medical Center, Inc.

  dba Covenant Healthcare

  • General Acute Care Hospital
  • Saginaw, MI
  • NPI 1588656946
  Care Compare affiliation

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1821657099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HOUGHTON AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 HALLMARK CT",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032109",
            "telephone_number": "989-746-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADWELL",
        "first_name": "JONATHAN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301505464",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MI",
            "license": "4301505464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "n/a",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "1000 Houghton Ave",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486025303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amee Marie Briney, MA, LPC, NCC, CCS
• Laura Lee Bringer
• Britany Lee Brissette
• Sharon L Brittain
• Kaitlyn Britton, BSW
• Kaleigh Brock
• Sierra Shyann Brock
• Debra L Brockman, CRNA
• Ketan Brodeur
• Allie Jade Brodsky

• Geriatric Psychiatry Physician in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Geriatric Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.