ELYSE RENEE BROUCEK NPI 1770180960

NPI Details

Elyse Renee Broucek is a physician assistant in Phoenix, AZ. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Elyse Renee Broucek NPI is 1770180960. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4045 E BELL RD STE 125
PHOENIX, AZ
ZIP 85032-238
Phone: (602) 971-0268

The NPI 1770180960 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.

• Repair of wound by transferring skin, 30.1-60.0 sq cm (HCPCS:14301)
• Repair of wound by transferring skin, each additional 30.0 sq cm (HCPCS:14302)
• Preparation of skin graft site of trunk, arms, or legs, 100.0 sq cm or 1% body area for infants and children, or less (HCPCS:15002)
• Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less (HCPCS:15004)
• Preparation of skin graft site of trunk, arms, or legs, each additional 100.0 sq cm or 1% body area for infants and children, or less (HCPCS:15003)
• Repair of wound by transferring skin, 30.1-60.0 sq cm (HCPCS:14301)
• Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less (HCPCS:15004)
• Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 10/1/2020 and was last updated on 2/4/2025.

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: