Christopher Matthew Broderick, FNP
Individual provider Active NPI Family Nurse Practitioner · Youngstown, OH
NPI 1831466549 · NPPES record last updated Sep 5, 2025
Key facts
- NPI
- 1831466549
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 12853-NP (OH)
- Practice address
- 726 Wick Ave
Youngstown, OH 44505-2827 - Phone
- (330) 747-9551
- Fax
- (330) 747-2740
- NPI assigned
- Nov 23, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ohio North East Health Systems Inc
Practice addresses (Care Compare)
1977 Niles Rd SE
Warren, OH 44484-5118
Phone (330) 393-6446
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120220000210 | OH | Practitioner - Nurse Practitioner | 2860650041 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12853-NP | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ohio North East Health Systems Inc | Current |
Accepting new patients | |
| Ohio North East Health Systems, Inc. | Current |
Accepting new patients | |
| Patriot Homecare, Inc. | Past |
Accepting new patients | |
| Psych Solutions Inc. | Past |
Accepting new patients | |
| Ohio North East Health Systems, Inc | Past | Accepting new patients |
Locations
1390 S Arch Ave
Alliance, OH 44601
Phone (330) 821-3961
2642 State Route 5
Cortland, OH 44410
Phone (330) 841-5500
175 E Broad St
Newton Falls, OH 44444
Phone (330) 747-9551
1977 Niles Rd SE
Warren, OH 44484
Phone (330) 372-5800
716 Tod Ave SW
Warren, OH 44485
Phone (330) 373-0222
1821 E Market St
Warren, OH 44483
Phone (330) 392-7000
3132 Belmont Ave
Youngstown, OH 44505
Phone (330) 759-0644
726 Wick Ave
Youngstown, OH 44505
Phone (330) 747-2330
Interoperability endpoints
- christopher.broderick.p1@direct.oho.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 12853-NP | OH | Yes |
Addresses
Primary practice location
726 Wick Ave
Youngstown, OH 44505-2827
Mailing address
726 Wick Ave
Youngstown, OH 44505-2827
Phone (330) 747-9551
Other practice location 1
175 E Broad St
Newton Falls, OH 44444-1708
Phone (330) 872-2010
Other practice location 2
3132 Belmont Ave
Youngstown, OH 44505-1838
Phone (844) 652-8219
Other practice location 3
1821 E Market St
Warren, OH 44483-6627
Phone (330) 392-7000
Other practice location 4
20265 Emery Rd
North Randall, OH 44128-4122
Phone (440) 523-9966
Other practice location 5
2642 State Route 5
Cortland, OH 44410-9393
Phone (330) 841-5500
Other practice location 6
1977 Niles Rd SE
Warren, OH 44484-5118
Phone (330) 393-6446
Other practice location 7
716 Tod Ave SW
Warren, OH 44485-3608
Phone (330) 373-0222
Other practice location 8
1390 S Arch Ave
Alliance, OH 44601-4111
Phone (330) 821-3961
Other practice location 9
20265 Emery Rd
North Randall, OH 44128-4122
Phone (440) 523-9966
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0057396 | Medicaid | OH |
Other providers in Youngstown, OH
- Emilie Brooke Brocious
- Matthew Brocious
- Antoniya Brock
- Beth A Brocker
- Brian P Brocker
- Brodmor Inc
- Robert Edward Broll Jr.
- Brookdale Senior Living Communities Inc
- Stephanie Lynn Brooke
- Apryl Brooks
All providers in Youngstown, OH · Family Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.