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BROADWAY FAMILY MEDICINE INC
NPI 1083696538
Family Medicine in Lebanon, OH

Active since November 18, 2005CLIA 36D0696811 · Microscopy
1470 N BROADWAY ST, SUITE100, LEBANON, OH 45036(513) 932-1936(513) 932-3105 Get Directions Write a Review

NPPES record last updated: September 20, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Broadway Family Medicine Inc NPPES

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

BROADWAY FAMILY MEDICINE INC (NPI 1083696538) is a healthcare organization registered as a family medicine in Lebanon, Ohio and active in the NPI registry since November 2005. The organization holds a CLIA Microscopy certificate valid through May 18, 2028 and lists Rose Ebel, President, as its authorized official.

NPPES Registry Identity

NPI1083696538
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBROADWAY FAMILY MEDICINE INC
Location Address1470 N BROADWAY ST, SUITE100Lebanon, OH 45036-1744
Mailing AddressPo Box 4723Belfast, ME 04915-4723 · (513) 932-1936 · Fax (513) 932-3105
Phone(513) 932-1936
Fax(513) 932-3105
Organization SubpartNo
Authorized OfficialRose EbelPresident · (513) 932-1936
Enumeration DateNovember 18, 2005
Last NPPES UpdateSeptember 20, 2018
✔ NPI 1083696538 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
1470 N BROADWAY ST, Lebanon, OH 45036
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Other Identifiers 2

Medicaid2378538OH
OtherCK5993OH · Rr Mcr

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Broadway Family Medicine Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Broadway Family Medicine Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Rose Ebel, DO
Family Practice
NPI 1619950656
1470 N BROADWAY ST STE 100
Lebanon, OH 45036
(513) 932-1936
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 36D0696811

Broadway Family Medicine, Inc · Lebanon, OH
Active · expires May 18, 2028
CLIA Number36D0696811
Laboratory TypePhysician Office
Certificate Effective DateMay 19, 2026
Certificate Expiration DateMay 18, 2028
Laboratory DirectorRose Ebel
Laboratory Phone(513) 932-1936
Laboratory LocationBroadway Family Medicine, Inc1470 N Broadway Street Suite 100, Lebanon, OH 45036
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Broadway Family Medicine Inc's NPI number?

The NPI number for Broadway Family Medicine Inc is 1083696538. It was assigned to this organization in the NPPES registry on November 18, 2005.

Where is Broadway Family Medicine Inc located?

Broadway Family Medicine Inc is located at 1470 N Broadway St Suite100, Lebanon, OH 45036. The listed phone number is (513) 932-1936.

What is Broadway Family Medicine Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Broadway Family Medicine Inc enrolled in Medicare?

Yes. Broadway Family Medicine Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Broadway Family Medicine Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Broadway Family Medicine Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Broadway Family Medicine Inc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 36D0696811) is associated with this NPI, valid through May 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Broadway Family Medicine Inc accept?

Health plans from Anthem Blue Cross and Blue Shield list Broadway Family Medicine Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Broadway Family Medicine Inc was last updated on September 20, 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.