Cassandra Broedell

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

291080 Issued in CA

Practice address

630 L St
Chula Vista, CA 91911-1066

Phone

(619) 271-7100

NPI assigned

Feb 8, 2022

Last updated

Feb 8, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Robert Marriott Medical Corp

  dba Advantage Wound Care

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938
  NPD (past)

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1831843952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 PINEWOOD CT",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585523",
            "telephone_number": "561-762-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 L ST",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919111066",
            "telephone_number": "619-271-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROEDELL",
        "first_name": "CASSANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "291080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danisia Ilona Nacpil Briones
• Eric R Briones, PA
• Melissa Ann Brito, NURSE PRACTITIONER
• Alberto O Broas, DDS
• Mark Brody, M.S. MFT
• Irene Merritt Brooks, RADT
• Reginald Crillin Brooks Jr.
• Ryan Brooks
• Alina French Broton, DO
• Abraham E Broudy, MD

• Physical Therapist in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.