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MR. NICHOLAS BROCCOLI DDS
NPI 1235679432
Dentist - Oral and Maxillofacial Surgery in Henrico, VA

Active since March 07, 2017Opted out of Medicare · through Apr 1, 2028
3811 WESTERRE PKWY, STE A, HENRICO, VA 23233(804) 354-1600(804) 354-1607 Get Directions Write a Review

NPPES record last updated: November 22, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 22, 2021, Nov 15, 2021, Jun 10, 2021 and 1 more (4 updates tracked since 2021).

About Mr. Nicholas Broccoli Dds NPPES

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

MR. NICHOLAS BROCCOLI DDS (NPI 1235679432) is an individual oral and maxillofacial surgery provider in Henrico, Virginia, licensed in Virginia (0401417373) and active in the NPI registry since March 2017. He has opted out of Medicare through April 1, 2028 and remains eligible to order and refer and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1235679432
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameMR. NICHOLAS BROCCOLICredential: DDS
Location Address3811 WESTERRE PKWY, STE AHenrico, VA 23233-1329
Mailing AddressPo Box 71930Richmond, VA 23255-1930 · (804) 354-1600 · Fax (804) 354-1607
Phone(804) 354-1600
Fax(804) 354-1607
Sole ProprietorNo
Enumeration DateMarch 7, 2017
Last NPPES UpdateNovember 22, 20214 updates tracked since enumeration
NPPES CertifiedNovember 22, 2021
✔ NPI 1235679432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in VA · 0401417373
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.
3811 WESTERRE PKWY, Henrico, VA 23233
Open in Google Maps ↗

Secondary Practice Locations 4

Location 18503 Patterson Ave Ste ARichmond, VA 23229-6442 · Phone (804) 354-1600 · Fax (804) 354-1607
Location 21807 Huguenot Rd Ste 120Midlothian, VA 23113-5604 · Phone (804) 354-1600 · Fax (804) 354-1607
Location 35942 Harbour Park DrMidlothian, VA 23112-2163 · Phone (804) 354-1600 · Fax (804) 354-1607
Location 412220 Iron Bridge Rd Ste BChester, VA 23831-1543 · Phone (804) 354-1600 · Fax (804) 354-1607

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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

Mr. Nicholas Broccoli Dds 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 April 1, 2024 through April 1, 2028.

Opt-Out Effective DateApril 1, 2024
Opt-Out In Effect ThroughApril 1, 2028Opt-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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more 99202
This service involves an initial visit to the doctor's office or other outpatient setting. It typically lasts between 15-29 minutes. The doctor will review your medical history, conduct a physical examination, and discuss your health concerns. It's a chance to establish your health baseline and address any immediate medical issues.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23233 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
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 2

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

DR. ROMAN T HAUEIS DMD
Dentist (General Practice)
3811 WESTERRE PKWY, SUITE C
HENRICO, VA 23233
Henrico County (804) 747-0116
SHORT PUMPS DENTAL
Dentist (General Practice)
3811 WESTERRE PKWY, SUITE C
HENRICO, VA 23233
Henrico County (804) 747-0116

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 Nicholas Broccoli's NPI number?

The NPI number for Nicholas Broccoli is 1235679432. It was assigned to this individual provider in the NPPES registry on March 7, 2017.

Where is Nicholas Broccoli located?

Nicholas Broccoli practices at 3811 Westerre Pkwy Ste A, Henrico, VA 23233. The listed phone number is (804) 354-1600.

What is Nicholas Broccoli's specialty?

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

Is Nicholas Broccoli enrolled in Medicare?

No. Nicholas Broccoli has opted out of Medicare through April 1, 2028. 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 Nicholas Broccoli accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Humana list Nicholas Broccoli 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 Nicholas Broccoli was last updated on November 22, 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.