DR. PETER BRODERICK M.D. M.ED. NPI 1285645002

NPI Information

  • NPI: 1285645002
  • Provider Name: DR. PETER BRODERICK, M.D., M.ED.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 401 PARADISE RD
    SUITE E
    MODESTO, CA
    ZIP 95351
  • Phone: (209) 558-4000

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NPI Details

DR. Peter Broderick, M.D., M.ED. is a family medicine in Modesto, CA with 39 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Peter Broderick, M.D., M.ED. NPI is 1285645002. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

401 PARADISE RD
SUITE E
MODESTO, CA
ZIP 95351-104
Phone: (209) 558-4000
Fax: (209) 558-5036

The NPI 1285645002 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), Power Mobility Devices.

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.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Injection, ketorolac tromethamine, per 15 mg (HCPCS:J1885)
  • Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen (HCPCS:87635)
  • Automated urinalysis test (HCPCS:81003)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
  • Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) (HCPCS:87880)
  • Detection test by immunoassay with direct visual observation for influenza virus (HCPCS:87804)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)

The enumeration date for this NPI number is 8/10/2006 and was last updated on 7/22/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineG63629CALIFORNIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100G636290MEDICARE ID-TYPE UNSPECIFIEDMCR INDIVIDUAL
2E50216MEDICARE UPIN

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: 11/21/2025

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