DR. NICOLE STACK BROERMAN MD
NPI 1013902741
Pediatrics in Hinesville, GA

Q: What is Nicole Broerman's NPI number?

The NPI number for Nicole Broerman is 1013902741. It was assigned to this individual provider in the NPPES registry on September 19, 2005. The provider is also known as Dr. Nicole Marie Stack MD.

Q: What is Nicole Broerman's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Broerman was last updated on April 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 19, 2005PECOS Enrolled

462 ELMA G MILES PKWY, HINESVILLE, GA 31313(912) 369-9400(912) 877-9438 Get Directions Write a Review

NPPES record last updated: April 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 17, 2018, Jan 26, 2017 (2 updates tracked since 2017).

On this page

About Dr. Nicole Stack Broerman Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE STACK BROERMAN MD (NPI 1013902741) is an individual pediatrics provider in Hinesville, Georgia, licensed in Georgia (47265) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013902741

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. NICOLE STACK BROERMANCredential: MD

Location Address462 ELMA G MILES PKWYHinesville, GA 31313-4000

Mailing AddressPo Box 919Hinesville, GA 31310-0919 · (912) 369-9400

Phone(912) 369-9400

Fax(912) 877-9438

Sole ProprietorYes

Enumeration DateSeptember 19, 2005

Last NPPES UpdateApril 17, 20182 updates tracked since enumeration

✔ NPI 1013902741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in GA · 47265

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

462 ELMA G MILES PKWY, Hinesville, GA 31313

Open in Google Maps ↗

Other Names 1

Former Name (1)Dr. Nicole Marie Stack Md

Other Identifiers 1

MedicaidT74835GA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicole Stack Broerman Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31313 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Leave this field empty

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOSPITAL AUTHORITY OF LIBERTY COUNTY

Clinic/Center