EKATERINA SHATALOVA BROOME MD
NPI 1184326738
Student in an Organized Health Care Education/Training Program in Miami, FL

Q: What is Ekaterina Broome's NPI number?

The NPI number for Ekaterina Broome is 1184326738. It was assigned to this individual provider in the NPPES registry on March 20, 2023. The provider is also known as Ekaterina Shatalova MD.

Q: What is Ekaterina Broome's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Ekaterina Broome was last updated on July 5, 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.

Active since March 20, 2023PECOS Enrolled

11880 BIRD RD STE 101, MIAMI, FL 33175(786) 315-5925 Get Directions Write a Review

NPPES record last updated: July 5, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 5, 2023, Jun 11, 2023, Mar 20, 2023 (3 updates tracked since 2023).

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About Ekaterina Shatalova Broome Md NPPES

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

EKATERINA SHATALOVA BROOME MD (NPI 1184326738) is an individual student in an organized health care education/training program in Miami, Florida and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184326738

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameEKATERINA SHATALOVA BROOMECredential: MD

Location Address11880 BIRD RD STE 101Miami, FL 33175-3573

Mailing Address11880 Bird Rd Ste 101Miami, FL 33175-3573

Phone(786) 315-5925

Sole ProprietorNo

Enumeration DateMarch 20, 2023

Last NPPES UpdateJuly 5, 20233 updates tracked since enumeration

NPPES CertifiedJuly 5, 2023

✔ NPI 1184326738 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

11880 BIRD RD STE 101, Miami, FL 33175

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Other Names 1

Former Name (1)Ekaterina Shatalova Md

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ekaterina Shatalova Broome 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.

Other Providers at the Same Location NPPES 10

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

ARIELIS ORTIZ MD

Internal Medicine