BROADWAY MEDICAL TREATMENT CENTER, LLC
NPI 1104010032
Family Medicine in East Providence, RI

Q: What is Broadway Medical Treatment Center, LLC's specialty?

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

Active since September 04, 2007

1053 S BROADWAY, EAST PROVIDENCE, RI 02914(401) 438-5551(401) 438-7272 Get Directions Write a Review

NPPES record last updated: September 4, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Broadway Medical Treatment Center, Llc NPPES

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

BROADWAY MEDICAL TREATMENT CENTER, LLC (NPI 1104010032) is a healthcare organization registered as a family medicine in East Providence, Rhode Island and active in the NPI registry since September 2007. The organization lists Peter George Brassard, Physician / Owner, as its authorized official.

NPPES Registry Identity

NPI1104010032

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameBROADWAY MEDICAL TREATMENT CENTER, LLC

Location Address1053 S BROADWAYEast Providence, RI 02914-4729

Mailing Address1053 S BroadwayEast Providence, RI 02914-4729 · (401) 438-5551 · Fax (401) 438-7272

Phone(401) 438-5551

Fax(401) 438-7272

Organization SubpartNo

Authorized OfficialPeter George BrassardPhysician / Owner · (401) 438-5551

Enumeration DateSeptember 4, 2007

✔ NPI 1104010032 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in RI · CMD 06972

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.

1053 S BROADWAY, East Providence, RI 02914

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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 SINGLE SPECIALTY GROUP

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 Medical Treatment Center, Llc 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 Medical Treatment Center, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Peter Brassard, M.D.

Family Practice

NPI 1609877489

1053 S BROADWAY
East Providence, RI 02914

(401) 438-5551

✔ 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.

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 Medical Treatment Center, LLC's NPI number?

The NPI number for Broadway Medical Treatment Center, LLC is 1104010032. It was assigned to this organization in the NPPES registry on September 4, 2007.

Where is Broadway Medical Treatment Center, LLC located?

Broadway Medical Treatment Center, LLC is located at 1053 S Broadway, East Providence, RI 02914. The listed phone number is (401) 438-5551.

What is Broadway Medical Treatment Center, LLC's specialty?

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

Is Broadway Medical Treatment Center, LLC enrolled in Medicare?

Yes. Broadway Medical Treatment Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Broadway Medical Treatment Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Broadway Medical Treatment Center, LLC. 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.

When was this NPI record last updated?

The NPPES record for Broadway Medical Treatment Center, LLC was last updated on September 4, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.