PETER J BROCCOLI
NPI 1356921142
Dentist - Oral and Maxillofacial Surgery in Midlothian, VA

Q: What is Peter Broccoli's NPI number?

The NPI number for Peter Broccoli is 1356921142. It was assigned to this individual provider in the NPPES registry on April 14, 2021.

Q: What is Peter Broccoli's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Peter Broccoli was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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 April 14, 2021PECOS Enrolled

1807 HUGUENOT RD STE 120, MIDLOTHIAN, VA 23113(804) 354-1600 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 23, 2025, Apr 14, 2021 (2 updates tracked since 2021).

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About Peter J Broccoli NPPES

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

PETER J BROCCOLI (NPI 1356921142) is an individual oral and maxillofacial surgery provider in Midlothian, Virginia, licensed in Virginia (0401419456) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and maintains a secondary practice location in Mechanicsville.

NPPES Registry Identity

NPI1356921142

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NamePETER J BROCCOLI

Location Address1807 HUGUENOT RD STE 120Midlothian, VA 23113-5604

Mailing AddressPo Box 71930Richmond, VA 23255-1930 · (804) 354-1600

Phone(804) 354-1600

Sole ProprietorNo

Enumeration DateApril 14, 2021

Last NPPES UpdateJune 23, 20252 updates tracked since enumeration

NPPES CertifiedJune 23, 2025

✔ NPI 1356921142 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 · 0401419456

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.

1807 HUGUENOT RD STE 120, Midlothian, VA 23113

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Secondary Practice Location 1

Location 17009 Lee Park RdMechanicsville, VA 23111-3682 · Phone (804) 354-1600

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

✔

Enrolled in Medicare (PECOS)

Peter J Broccoli 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 23113 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.

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 Peter Broccoli's NPI number?

The NPI number for Peter Broccoli is 1356921142. It was assigned to this individual provider in the NPPES registry on April 14, 2021.

Where is Peter Broccoli located?

Peter Broccoli practices at 1807 Huguenot Rd Ste 120, Midlothian, VA 23113. The listed phone number is (804) 354-1600.

What is Peter Broccoli's specialty?

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

Is Peter Broccoli enrolled in Medicare?

Yes. Peter Broccoli is registered in the Medicare PECOS enrollment system.

What insurance does Peter 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 Peter 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 Peter Broccoli was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.