Arthur Paul Broaderick, MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

ME69348 Issued in FL

Practice address

2190 Highway 85 N
Niceville, FL 32578-1045

Phone

(352) 867-8898

Fax

(352) 732-6282

NPI assigned

Sep 16, 2006

Last updated

Aug 12, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

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

Anesthesiology

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Twin Cities Anesthesia Associates PLGroup PAC ID 5092954222, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Twin Cities Anesthesia Associates, PL

  • Anesthesiology Physician
  • Niceville, FL
  • NPI 1497199731
  Medicare reassignment Care Compare group NPD Authorized official
• Bayshore Anesthesia P a

  • Pain Medicine (Anesthesiology) Physician
  • Niceville, FL
  • NPI 1659477461
  NPD Authorized official
• Martin County Anesthesia Group PL

  • Pain Medicine (Anesthesiology) Physician
  • Stuart, FL
  • NPI 1487606075
  NPD (past)

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

• Okaloosa Hospital Inc

  dba HCA Florida Twin Cities Hospital

  • General Acute Care Hospital
  • Niceville, FL
  • NPI 1891732988
  Care Compare affiliation

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313107200000",
    "number": "1922104678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7419",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917419",
            "telephone_number": "352-867-8898",
            "fax_number": "352-732-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 HIGHWAY 85 N",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781045",
            "telephone_number": "352-867-8898",
            "fax_number": "352-732-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROADERICK",
        "first_name": "ARTHUR",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "FL",
            "license": "ME69348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "28253X",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379870400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "28253",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050074614",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda L Brenci, O.D.
• Brenda K Moore DO PA
• Carmen Y. Brezna, LCSW, MSW
• Charles Bridges IV
• Laura Ann Brisby, FNP-BC
• Patricia Lynn Brobeck, O.D.
• Kellie Kaiser Brock, NURSE PRACTITIONER
• Dawn A Brognano, PT
• Olivier Broutin, D.M.D.
• Jennifer Ann Brown

• Pain Medicine (Anesthesiology) Physician in Niceville, FL
• Providers in Niceville, FL by specialty
• Pain Medicine (Anesthesiology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2011; 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.