BROC HAMMON D.M.D.
NPI 1154720167
Dentist - Oral and Maxillofacial Surgery in Scott Afb, IL

Q: What is Broc Hammon's NPI number?

The NPI number for Broc Hammon is 1154720167. It was assigned to this individual provider in the NPPES registry on August 14, 2014.

Q: What is Broc Hammon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: Is Broc Hammon enrolled in Medicare?

No. Broc Hammon has opted out of Medicare through September 13, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Broc Hammon was last updated on February 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since August 14, 2014Opted out of Medicare · through Sep 13, 2027

310 W LOSEY ST, SCOTT AFB, IL 62225(618) 256-9355(618) 256-7018 Get Directions Write a Review

NPPES record last updated: February 15, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Broc Hammon D.m.d. NPPES

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

BROC HAMMON D.M.D. (NPI 1154720167) is an individual oral and maxillofacial surgery provider in Scott Afb, Illinois, licensed in Illinois (019.032972) and active in the NPI registry since August 2014. He has opted out of Medicare through September 13, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1154720167

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameBROC HAMMONCredential: D.M.D.

Location Address310 W LOSEY STScott Afb, IL 62225-5250

Mailing Address101 Bodin CirTravis Afb, CA 94535

Phone(618) 256-9355

Fax(618) 256-7018

Sole ProprietorNo

Enumeration DateAugust 14, 2014

Last NPPES UpdateFebruary 15, 2022

NPPES CertifiedFebruary 15, 2022

✔ NPI 1154720167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in IL · 019.032972

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedDentistTaxonomy 122300000X · License 9047230-9921 (UT)

310 W LOSEY ST, Scott Afb, IL 62225

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, BEST Life and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Broc Hammon D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 13, 2023 through September 13, 2027.

Opt-Out Effective DateSeptember 13, 2023

Opt-Out In Effect ThroughSeptember 13, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62225 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$70.42 typical visit price

range $17.51 – $139.99

Typical copayment $17.60 (range $4.37 – $34.99)

Most-billed visit code 99213

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 20

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

DR. TODD ALAN SCHULTZ D.M.D.

Dentist (Oral and Maxillofacial Surgery)

310 W LOSEY ST
SCOTT AFB, IL 62225

St. Clair County (618) 256-7079

DAWN WILSON PT

Physical Therapist

310 W LOSEY ST
SCOTT AFB, IL 62225

St. Clair County (618) 256-6267

MR. SEAN J MCNAMARA RPH.

Pharmacist

310 W LOSEY ST
SCOTT AFB, IL 62225

St. Clair County (618) 256-6150

DR. PATSY FRANCES KREMSREITER MD

Family Medicine

310 W LOSEY ST
SCOTT AFB, IL 62225

St. Clair County (618) 256-9355

JOAN FOMBOH TELAZIE-SIMONS RN

Registered Nurse

310 W LOSEY ST
SCOTT AIR FORCE BASE, IL 62225

St. Clair County (618) 256-9355

DR. SARAH KATHERINE TURBUSH DDS

Dentist (Prosthodontics)

310 W LOSEY ST
SCOTT AFB, IL 62225

St. Clair County (618) 256-6667

DR. CASEY TIMMERMAN DO

Obstetrics & Gynecology

310 W LOSEY ST
SCOTT AFB, IL 62225

St. Clair County (618) 256-7669

CHRISTINE LEIGH KMIECIK

Social Worker (Clinical)

310 W LOSEY ST
SCOTT AIR FORCE BASE, IL 62225

St. Clair County (618) 256-9355

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 Broc Hammon's NPI number?

The NPI number for Broc Hammon is 1154720167. It was assigned to this individual provider in the NPPES registry on August 14, 2014.

Where is Broc Hammon located?

Broc Hammon practices at 310 W Losey St, Scott Afb, IL 62225. The listed phone number is (618) 256-9355.

What is Broc Hammon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Broc Hammon enrolled in Medicare?

No. Broc Hammon has opted out of Medicare through September 13, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Broc Hammon accept?

Health plans from Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Broc Hammon 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 Broc Hammon was last updated on February 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.