VADJISTA BROUMAND MD
NPI 1376537308
Internal Medicine in Fayetteville, NY
About Vadjista Broumand Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
VADJISTA BROUMAND MD (NPI 1376537308) is an individual internal medicine provider in Fayetteville, New York, licensed in New York (235818) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS and is a graduate of University Of Miami, Lm Miller School Of Medicine (2000).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Vadjista Broumand Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Vadjista Broumand reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fayetteville, NY 13066
- Reassigned Medicare billing, New York enrollment
- 15 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 13066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
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.
FAYETTEVILLE, NY 13066
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 Vadjista Broumand's NPI number?
The NPI number for Vadjista Broumand is 1376537308. It was assigned to this individual provider in the NPPES registry on September 6, 2005.
Where is Vadjista Broumand located?
Vadjista Broumand practices at 4110 Medical Center Dr Suite 110, Fayetteville, NY 13066. The listed phone number is (315) 663-0100.
What is Vadjista Broumand's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Vadjista Broumand enrolled in Medicare?
Yes. Vadjista Broumand is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Vadjista Broumand's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Vadjista Broumand reassigns Medicare benefits to Dr. Fazeli & Dr. Broumand LLC (Fayetteville, NY). 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 Vadjista Broumand's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Vadjista Broumand was last updated on December 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Vadjista Broumand, MD · NPI 1376537308
Internal Medicine physician in Fayetteville, New York. Individual provider, active in the CMS NPPES registry since September 6, 2005.
## Identity
- **NPI:** 1376537308 (Entity type: Individual)
- **Enumerated:** September 6, 2005
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **State license:** 235818 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 4110 MEDICAL CENTER DR, SUITE 110, Fayetteville, NY 13066
- **Phone:** (315) 663-0100 · **Fax:** (315) 663-0052
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Dr. Fazeli & Dr. Broumand LLC (NPI 1336235639, Fayetteville, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Miami, Lm Miller School Of Medicine, class of 2000
## Record status
- **NPPES last updated:** December 10, 2014
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Source: [NPI Profile](https://npiprofile.com/npi/1376537308) · Data from the CMS NPPES public registry.