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

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: October 18, 2026.

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, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Anthony Broderick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Musc Community Physicians
2,104 mi
Internal Medicine
506 NORTH ST
Bamberg, SC 29003
  • Reassigned Medicare billing, South Carolina enrollment
  • 2,389 clinicians in this Medicare group
NPI 1841878006 (803) 245-6290

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

CHRISTINA CRABTREE M.D.
Emergency Medicine
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
SCOTT GEYER RD
Dietitian, Registered
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
DR. MATTHEW KUNZ DO
Emergency Medicine
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
MRS. AMANDA K KAMPF RN, BSN
Student in an Organized Health Care Education/Training Program
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
DR. PATRICK WILLIAM MAGAJNA MD
Emergency Medicine
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4000
JOSHUA LEPPERT CRNA
Nurse Anesthetist, Certified Registered
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 765-8585
MARC OLAV GRANRUD
Hospitalist
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6900
KIMBERLEY S HALL DIETICIAN
Dietitian, Registered
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 666-2000

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 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.

Where is Anthony Broderick located?

Anthony Broderick practices at 2003 Kootenai Health Way, Coeur D Alene, ID 83814. The listed phone number is (208) 625-5185.

What is Anthony Broderick's specialty?

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

Is Anthony Broderick enrolled in Medicare?

Yes. Anthony Broderick is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Anthony Broderick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Anthony Broderick reassigns Medicare benefits to Musc Community Physicians (Bamberg, SC). 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 Anthony Broderick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Anthony Broderick accept?

Health plans from BlueCross BlueShield of South Carolina, First Choice Next, Molina Healthcare and UnitedHealthcare list Anthony Broderick 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 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 7 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.