Individual provider Active NPI

Adam Michael Bromberg, MD

  • Emergency Medicine Physician
  • Wellington, FL
National Provider Identifier
1962616367
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME100188 Issued in FL
Practice address
10101 Forest Hill Blvd
Wellington, FL 33414-6103
Phone
(561) 798-8535
NPI assigned
May 9, 2007
Last updated
Apr 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 90141 OH
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X ME100188 FL Primary

Addresses

Primary practice location

10101 Forest Hill Blvd
Wellington, FL 33414-6103

Mailing address

31 McCullogh Dr
Springboro, OH 45066-7803

Other practice location 1

3535 Southern Blvd
Kettering, OH 45429-1221
Phone (937) 395-8609

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080708000507 FL Practitioner - Emergency Medicine 5698863827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Em Alliance LLCGroup PAC ID 4789039058, 16 clinicians

Practice addresses (Care Compare)

10101 Forest Hill Blvd
Wellington, FL 33414-6103
Phone (904) 334-0910

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME100188FLMDEmergency Medicine Physician
90141OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Radiology Services LLC CurrentSince Aug 1, 2023 Accepting new patients
Acute Care Associates of California PC Emergency Medicine Current Accepting new patients
Em Alliance California, Apc Emergency Medicine CurrentSince Mar 1, 2024 Accepting new patients
Em Alliance LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Miami Valley Emergency Specialists, LLC Emergency Medicine Past Accepting new patients
Samaritan Emergency Corp Emergency Medicine Past Accepting new patients

Locations

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

10101 Forest Hill Blvd
West Palm Beach, FL 33414
Phone (561) 766-1301

1155 S Congress Ave
Ste C
West Palm Beach, FL 33406
Phone 5617661300601

16750 Persimmon Blvd
Westlake, FL 33470
Phone (561) 791-7200

7 Easton Oval
#L4387
Columbus, OH 43219

Organizations & group practices 6

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.

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1962616367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MCCULLOGH DR",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450667803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146103",
            "telephone_number": "561-798-8535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROMBERG",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "90141",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME100188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.