DR. GREGORY BRODERICK-VILLA MD
NPI 1376571562
Surgery in Oakland, CA

Q: What is Gregory Broderick-villa's NPI number?

The NPI number for Gregory Broderick-villa is 1376571562. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Q: What is Gregory Broderick-villa's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since June 28, 2006PECOS EnrolledAccepts Medicare Assignment

365 HAWTHORNE AVE, 101, OAKLAND, CA 94609(510) 465-5523 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Gregory Broderick-villa Md NPPES

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

DR. GREGORY BRODERICK-VILLA MD (NPI 1376571562) is an individual surgery provider in Oakland, California, licensed in California (A82944) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Tufts University School Of Medicine (2001).

NPPES Registry Identity

NPI1376571562

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameDR. GREGORY BRODERICK-VILLACredential: MD

Location Address365 HAWTHORNE AVE, 101Oakland, CA 94609-3107

Mailing Address2345 Country Hills DrAntioch, CA 94509-7319 · (925) 418-0278

Phone(510) 465-5523

Sole ProprietorNo

Medical School CMSTufts University School Of MedicineGraduated 2001

Enumeration DateJune 28, 2006

Last NPPES UpdateDecember 27, 2021

✔ NPI 1376571562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in CA · A82944

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

365 HAWTHORNE AVE, Oakland, CA 94609

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gregory Broderick-villa 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.

PECOS PAC ID2668475229

PECOS Enrollment IDI20060821000328

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 94609 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

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

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 20

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

MR. HON FONG MD

Obstetrics & Gynecology (Gynecology)

365 HAWTHORNE AVE, SUITE 301
OAKLAND, CA 94609

Alameda County (510) 893-1700

ERIC L JOHNSON MD

Internal Medicine (Interventional Cardiology)

365 HAWTHORNE AVE, #201
OAKLAND, CA 94609

Alameda County (510) 452-1345

AARON PETERS PA-C

Physician Assistant (Surgical)

365 HAWTHORNE AVE
OAKLAND, CA 94609

Alameda County (510) 465-5523

AJAY KUMAR UPADHYAY MD

Surgery

365 HAWTHORNE AVE, STE 101
OAKLAND, CA 94609

Alameda County (510) 465-5523

RUPERT ROUPEN HOROUPIAN MD

Surgery

365 HAWTHORNE AVE, SUITE 101
OAKLAND, CA 94609

Alameda County (510) 465-5523

MR. THOMAS LEE HAMBRICK MD

Obstetrics & Gynecology

365 HAWTHORNE AVE, SUITE 301
OAKLAND, CA 94609

Alameda County (510) 893-1700

MR. EDWARD MARTIN BLUMENSTOCK MD

Obstetrics & Gynecology

365 HAWTHORNE AVE, STE 301
OAKLAND, CA 94609

Alameda County (510) 893-1700

MS. GOLDEE HANNAH GROSS MD

Obstetrics & Gynecology

365 HAWTHORNE AVE, STE 301
OAKLAND, CA 94609

Alameda County (510) 893-1700

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 Gregory Broderick-villa's NPI number?

The NPI number for Gregory Broderick-villa is 1376571562. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is Gregory Broderick-villa located?

Gregory Broderick-villa practices at 365 Hawthorne Ave 101, Oakland, CA 94609. The listed phone number is (510) 465-5523.

What is Gregory Broderick-villa's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Gregory Broderick-villa enrolled in Medicare?

Yes. Gregory Broderick-villa 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.

When was this NPI record last updated?

The NPPES record for Gregory Broderick-villa was last updated on December 27, 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.