MATTHEW A BROOM MD
NPI 1114967767
Pediatrics in St. Louis, MO

Active since June 08, 2006PECOS Enrolled
1465 S GRAND BLVD, ST. LOUIS, MO 63104(314) 268-4070(314) 268-4021 Get Directions Write a Review

NPPES record last updated: July 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 28, 2023, Jan 18, 2021, May 28, 2019 (3 updates tracked since 2019).

About Matthew A Broom Md NPPES

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

MATTHEW A BROOM MD (NPI 1114967767) is an individual pediatrics provider in St. Louis, Missouri, licensed in Missouri (2006004155) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1114967767
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameMATTHEW A BROOMCredential: MD
Location Address1465 S GRAND BLVDSt. Louis, MO 63104-1003
Mailing Address1465 S Grand BlvdSaint Louis, MO 63104-1003 · (314) 268-4070 · Fax (314) 268-4021
Fax(314) 268-4021
Sole ProprietorNo
Enumeration DateJune 8, 2006
Last NPPES UpdateJuly 28, 20233 updates tracked since enumeration
NPPES CertifiedJuly 28, 2023
NPI 1114967767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License Licensed in MO · 2006004155
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.
Also ListedPediatrics · Pediatric Emergency MedicineTaxonomy 2080P0204X · License 2006004155 (MO)
1465 S GRAND BLVD, St. Louis, MO 63104

Secondary Practice Location 1

Location 1660 Mason Ridge Center DrSaint Louis, MO 63141-8509 · Phone (314) 273-6481

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Matthew A Broom 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 63104 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$69.89 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$34.29 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Psychologist (Clinical)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Anesthesiologist Assistant
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Dietitian, Registered (Nutrition, Pediatric)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Pediatrics (Child Abuse Pediatrics)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
Pediatrics
1465 S GRAND BLVD
ST. LOUIS, MO 63104
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD, DIVISION OF PEDIATRIC CRITICAL CARE
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD
SAINT LOUIS, MO 63104

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 Matthew Broom's NPI number?

The NPI number for Matthew Broom is 1114967767. It was assigned to this individual provider in the NPPES registry on June 8, 2006.

Where is Matthew Broom located?

Matthew Broom practices at 1465 S Grand Blvd, St. Louis, MO 63104. The listed phone number is (314) 268-4070.

What is Matthew Broom's specialty?

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

Is Matthew Broom enrolled in Medicare?

Yes. Matthew Broom is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Matthew Broom was last updated on July 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.