Individual provider Active NPI

Ronald A Brodkin, D.C.

  • Neurology Chiropractor
  • Boca Raton, FL
National Provider Identifier
1942298260
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
CH4412 Issued in FL
Practice address
7805 NW Beacon Square Blvd
Suite 103
Boca Raton, FL 33487-1395
Phone
(561) 620-0174
Fax
(561) 988-2125
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X CH4412 FL Primary

Addresses

Primary practice location

7805 NW Beacon Square Blvd
Suite 103
Boca Raton, FL 33487-1395

Mailing address

1640 NW Boca Raton Blvd
Boca Raton, FL 33432-1614
Phone (561) 620-0174

Other identifiers 1

IdentifierTypeStateIssuer
380584100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090108000624 FL Practitioner - Chiropractic 7113080771 Practice locations: Boca Raton, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brodkin Chiropractic and Acupuncture Neurology PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1942298260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 NW BOCA RATON BLVD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321614",
            "telephone_number": "561-620-0174",
            "fax_number": "561-620-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7805 NW BEACON SQUARE BLVD",
            "address_2": "SUITE 103",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334871395",
            "telephone_number": "561-620-0174",
            "fax_number": "561-988-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODKIN",
        "first_name": "RONALD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH4412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380584100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.