ANTHONY R BRODERICK NP
NPI 1194820555
Nurse Practitioner in Coeur D Alene, ID

Q: What is Anthony Broderick's NPI number?

The NPI number for Anthony Broderick is 1194820555. It was assigned to this individual provider in the NPPES registry on September 13, 2006.

Q: What is Anthony Broderick's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Anthony Broderick was last updated on August 28, 2019. 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.

Active since September 13, 2006PECOS Enrolled

2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814(208) 625-5185(208) 625-6892 Get Directions Write a Review

NPPES record last updated: August 28, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Anthony R Broderick Np NPPES

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

ANTHONY R BRODERICK NP (NPI 1194820555) is an individual nurse practitioner in Coeur D Alene, Idaho, licensed in Idaho (RN33608) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194820555

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameANTHONY R BRODERICKCredential: NP

Location Address2003 KOOTENAI HEALTH WAYCoeur D Alene, ID 83814-6051

Mailing Address2003 Kootenai Health WayCoeur D Alene, ID 83814-6051 · (208) 625-5085 · Fax (208) 625-5731

Phone(208) 625-5185

Fax(208) 625-6892

Sole ProprietorNo

Enumeration DateSeptember 13, 2006

Last NPPES UpdateAugust 28, 2019

✔ NPI 1194820555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Licenses✔ Licensed in ID · RN33608✔ Licensed in ID · NP675A

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2003 KOOTENAI HEALTH WAY, Coeur D Alene, ID 83814

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of South Carolina, First Choice Next, 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 (PECOS)

Anthony R Broderick Np 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 83814 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

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.

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