TODD G. BROBERG MD
NPI 1174682777
Otolaryngology - Plastic Surgery within the Head & Neck in San Diego, CA
About Todd G. Broberg Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TODD G. BROBERG MD (NPI 1174682777) is an individual plastic surgery within the head & neck provider in San Diego, California, licensed in California (G79418) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, San Francisco School Of Medicine (1993).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Todd G. Broberg Md 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.
Medicare Billing Reassignment
Medicare enrollment records show Todd Broberg reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Diego, CA 92120
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1023425972 (California)
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
SAN DIEGO, CA 92120
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 Todd Broberg's NPI number?
The NPI number for Todd Broberg is 1174682777. It was assigned to this individual provider in the NPPES registry on December 8, 2006.
Where is Todd Broberg located?
Todd Broberg practices at 4647 Zion Ave, San Diego, CA 92120. The listed phone number is (619) 528-5000.
What is Todd Broberg's specialty?
The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.
Is Todd Broberg enrolled in Medicare?
Yes. Todd Broberg 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.
Which organization bills Medicare for Todd Broberg's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Todd Broberg reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, CA). The 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 Todd Broberg's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Todd Broberg was last updated on November 30, 2021. 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.
# Todd G. Broberg, MD · NPI 1174682777
Plastic Surgery within the Head & Neck physician in San Diego, California. Individual provider, active in the CMS NPPES registry since December 8, 2006.
## Identity
- **NPI:** 1174682777 (Entity type: Individual)
- **Enumerated:** December 8, 2006
- **Primary specialty:** Otolaryngology - Plastic Surgery within the Head & Neck · taxonomy 207YX0007X
- **State license:** G79418 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 4647 ZION AVE, San Diego, CA 92120-2507
- **Phone:** (619) 528-5000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1225060742, San Diego, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of California, San Francisco School Of Medicine, class of 1993
## Record status
- **NPPES last updated:** November 30, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1174682777) · Data from the CMS NPPES public registry.