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JAMES EDWARD BRODERICK DPM NPI 1093726473


NPI Information

NPI: 1093726473
Provider Name: JAMES EDWARD BRODERICK, DPM
Classification: Podiatrist - 213ES0131X
Entity Type: Individual

Specialization: Foot Surgery

PECOS Registration: Yes

Address:
470 S PEARL ST
CANANDAIGUA, NY
ZIP 14424
Phone: (585) 394-4070
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James Edward Broderick, DPM is a foot surgery podiatrist in Canandaigua, NY with 36 years of experience. James Edward Broderick, DPM NPI is 1093726473. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduation Year:1988

The provider's business location address is:

470 S PEARL ST
CANANDAIGUA, NY
ZIP 14424
Phone: (585) 394-4070
Fax: (585) 394-8563

The NPI 1093726473 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Removal of tissue from 6 or more finger or toe nails (HCPCS:11721)
  • Removal of tissue from 1 to 5 finger or toe nails (HCPCS:11720)

The enumeration date for this NPI number is 8/10/2006 and was last updated on 11/22/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1213ES0131XPodiatristFoot SurgeryN004540NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101158323MEDICAIDNEW YORK
251912BMEDICARE PIN
34938460001MEDICARE NSCNEW YORK
4480007845OTHERNEW YORKRR MEDICARE
58110OTHERNEW YORKROCHESTER BL SHIELD
6T92375MEDICARE UPIN
751912BMEDICARE ID-TYPE UNSPECIFIEDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.