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CHRISTOPHER EVERETT BRODERICK DO
NPI 1063753390
Emergency Medicine in Latham, NY

Active since March 12, 2013PECOS Enrolled
13 CORNELL RD STE 2, LATHAM, NY 12110(518) 348-3176 Get Directions Write a Review

NPPES record last updated: March 14, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 14, 2025, Oct 19, 2021, Jul 30, 2021 and 1 more (4 updates tracked since 2017).

About Christopher Everett Broderick Do NPPES

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

CHRISTOPHER EVERETT BRODERICK DO (NPI 1063753390) is an individual emergency medicine provider in Latham, New York, licensed in New York (288755) and active in the NPI registry since March 2013. He is enrolled in Medicare PECOS and maintains a secondary practice location in Irving.

NPPES Registry Identity

NPI1063753390
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameCHRISTOPHER EVERETT BRODERICKCredential: DO
Location Address13 CORNELL RD STE 2Latham, NY 12110-1425
Mailing Address13 Cornell Rd Ste 2Latham, NY 12110-1425
Phone(518) 348-3176
Sole ProprietorNo
Enumeration DateMarch 12, 2013
Last NPPES UpdateMarch 14, 20254 updates tracked since enumeration
NPPES CertifiedMarch 14, 2025
✔ NPI 1063753390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Licenses✔ Licensed in NY · 288755✔ Licensed in TX · T2123
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
13 CORNELL RD STE 2, Latham, NY 12110
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Secondary Practice Location 1

Location 16363 N State Highway 161 Ste 100Irving, TX 75038-2239 · Phone (469) 200-3272

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Christopher Everett Broderick Do 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 12110 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
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.

Other Providers at the Same Location NPPES

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

LAURA SNYDER NP
Nurse Practitioner
13 CORNELL RD STE 2
LATHAM, NY 12110
Albany County (518) 348-3176

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Christopher Broderick's NPI number?

The NPI number for Christopher Broderick is 1063753390. It was assigned to this individual provider in the NPPES registry on March 12, 2013.

Where is Christopher Broderick located?

Christopher Broderick practices at 13 Cornell Rd Ste 2, Latham, NY 12110. The listed phone number is (518) 348-3176.

What is Christopher Broderick's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Christopher Broderick enrolled in Medicare?

Yes. Christopher Broderick is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Christopher Broderick was last updated on March 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.