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SHANA MARIE BROUSSARD
NPI 1134740798
Nurse Practitioner - Family in Vancleave, MS

Active since May 05, 2020PECOS EnrolledAccepts Medicare Assignment
10404 TUCKER RD # LLC, VANCLEAVE, MS 39565(228) 354-9505 Get Directions Write a Review

NPPES record last updated: June 24, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 24, 2020, May 5, 2020 (2 updates tracked since 2020).

About Shana Marie Broussard NPPES

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

SHANA MARIE BROUSSARD (NPI 1134740798) is an individual family provider in Vancleave, Mississippi, licensed in Mississippi (903748) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital At Gulfport, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1134740798
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSHANA MARIE BROUSSARD
Location Address10404 TUCKER RD # LLCVancleave, MS 39565-7922
Mailing Address4511 Lynn DrBiloxi, MS 39532-9477 · (228) 860-1773
Phone(228) 354-9505
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMay 5, 2020
Last NPPES UpdateJune 24, 20202 updates tracked since enumeration
NPPES CertifiedJune 24, 2020
✔ NPI 1134740798 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MS · 903748
10404 TUCKER RD # LLC, Vancleave, MS 39565
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Blue Cross Blue Shield of North Dakota, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shana Marie Broussard is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1355763871
PECOS Enrollment IDI20200629003038
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
24 services12 patients
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880
A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.
17 services17 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426
An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
14 services14 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
11 services11 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital At Gulfport

Acute Care Hospitals · Gulfport, MS
2/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number250019
Location4500 13th StreetGulfport, MS 39502 · Harrison County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39565 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
$80.50 typical visit price
range $51.65 – $159.18
Typical copayment $20.12 (range $12.91 – $39.79)
Most-billed visit code 99203
Established Patient
$92.20 typical visit price
range $16.15 – $129.61
Typical copayment $23.05 (range $4.03 – $32.40)
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.

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 Shana Broussard's NPI number?

The NPI number for Shana Broussard is 1134740798. It was assigned to this individual provider in the NPPES registry on May 5, 2020.

Where is Shana Broussard located?

Shana Broussard practices at 10404 Tucker Rd # LLC, Vancleave, MS 39565. The listed phone number is (228) 354-9505.

What is Shana Broussard's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shana Broussard enrolled in Medicare?

Yes. Shana Broussard is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shana Broussard accept?

Health plans from Blue Cross Blue Shield of North Dakota, Blue Cross and Blue Shield of Alabama, Molina Healthcare and Oscar Health Plan, Inc. list Shana Broussard 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.

Is Shana Broussard affiliated with any hospitals?

According to CMS data, Shana Broussard is affiliated with Memorial Hospital At Gulfport.

When was this NPI record last updated?

The NPPES record for Shana Broussard was last updated on June 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.