Individual provider Active NPI

Nicole M Broden, MD

  • Surgery Physician
  • Roanoke, VA
National Provider Identifier
1891352928
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101284289 Issued in VA
Practice address
3 Riverside Cir
Roanoke, VA 24016-4955
Phone
(540) 224-5170
NPI assigned
May 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 101284289 VA
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 0101284289 VA Primary

Addresses

Primary practice location

3 Riverside Cir
Roanoke, VA 24016-4955

Mailing address

1441 N 12TH St FL 1
Phoenix, AZ 85006-2837
Phone (602) 521-5981

Other practice location 1

1441 N 12th St Fl 1
Phoenix, AZ 85006-2837
Phone (602) 521-5981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20250819004774 VA Practitioner - General Surgery 6608100326 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

101 Elm Ave
Roanoke, VA 24013-2222
Phone (540) 224-4380

101 Elm Ave SE
FL 3
Roanoke, VA 24013-2222
Phone (540) 224-6780

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

3 Riverside Cir
Roanoke, VA 24016-4955
Phone (540) 224-5170

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101284289VAMDSurgery Physician
101284289VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Aug 1, 2025 Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Aug 1, 2025 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 1, 2025 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Aug 1, 2025 Accepting new patients
Carilion Medical Center CurrentSince Aug 1, 2025 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 1, 2025 Accepting new patients
Carilion Franklin Memorial Hospital CurrentSince Aug 1, 2025 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

2900 Lamb Cir
Ste 310
Christiansburg, VA 24073

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

100 Spotswood Dr
Lexington, VA 24450
Phone (540) 463-7108

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

3 Riverside Cir
Roanoke, VA 24016

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

101 Elm Ave SE
Roanoke, VA 24013
Phone (540) 985-8000

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

180 Floyd Ave
Rocky Mount, VA 24151
Phone (540) 483-5277

390 S Main St
Ste 302
Rocky Mount, VA 24151
Phone (540) 484-4855

Interoperability endpoints

  • Direct secure messaging: nbroden196132@direct.carilionclinic.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1891352928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5981",
            "fax_number": "602-521-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164955",
            "telephone_number": "540-224-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1441 N 12th St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062837",
            "country_code": "US",
            "telephone_number": "602-521-5981",
            "fax_number": "602-521-5981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRODEN",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "101284289",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101284289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.