Nicole Broden, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3996 Issued in MN

Practice address

20710 Keokuk Ave
Lakeville, MN 55044-6620

Phone

(612) 354-5931

NPI assigned

Jun 23, 2019

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

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

New England College of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

First Choice Health Centers IncGroup PAC ID 2769417609, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1215923131
  Medicare reassignment Care Compare group NPD
• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1215518733
  NPD
• First Choice Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Vernon, CT
  • NPI 1669874855
  NPD

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

{
    "created_epoch": "1561248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1891356606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20710 KEOKUK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446620",
            "telephone_number": "612-354-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20710 KEOKUK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446620",
            "telephone_number": "612-354-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODEN",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-23",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridge of Life Assisted Living LLC
• Bridgeway Care Services LLC
• Bright Futures Residence LLC
• Brightline Wellness LLC
• Emily Bristlin, BCBA
• Brooke Bush
• Laura Brown, MA, LPCC
• Rebecca May Brown, M.A.
• Simpson Brown
• Rebecca Diane Brubaker, CFP

• Optometrist in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; 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.