DR. SHANNON M BRODERSEN M.D.
NPI 1396938916
Family Medicine in Spokane Valley, WA

Q: What is Shannon Brodersen's NPI number?

The NPI number for Shannon Brodersen is 1396938916. It was assigned to this individual provider in the NPPES registry on August 27, 2007.

Q: What is Shannon Brodersen's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Brodersen was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 August 27, 2007PECOS EnrolledAccepts Medicare Assignment

16528 E DESMET CT STE B2100, SPOKANE VALLEY, WA 99216(509) 944-9440(509) 227-7070 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 10, 2025, Apr 30, 2021 (2 updates tracked since 2021).

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About Dr. Shannon M Brodersen M.d. NPPES

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

DR. SHANNON M BRODERSEN M.D. (NPI 1396938916) is an individual family medicine provider in Spokane Valley, Washington, licensed in Washington (MD 60474752) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS, is affiliated with Prov Sacred Hrt Med Ctr & Childs Hosp., and maintains a secondary practice location in Fairchild Afb.

NPPES Registry Identity

NPI1396938916

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SHANNON M BRODERSENCredential: M.D.

Location Address16528 E DESMET CT STE B2100Spokane Valley, WA 99216-3522

Mailing AddressPob 31001-4114Pasadena, CA 91110-0001 · (866) 747-2455 · Fax (509) 944-9644

Phone(509) 944-9440

Fax(509) 227-7070

Sole ProprietorNo

Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2007

Enumeration DateAugust 27, 2007

Last NPPES UpdateSeptember 10, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 10, 2025

✔ NPI 1396938916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WA · MD 60474752

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

16528 E DESMET CT STE B2100, Spokane Valley, WA 99216

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Secondary Practice Location 1

Location 1701 Hospital LoopFairchild AFB, WA 99011-8704 · Phone (509) 247-2361

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

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. Shannon M Brodersen M.d. 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 ID941529044

PECOS Enrollment IDI20150511002284

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.

Areas of Expertise CMS Part B claims 5

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

190 services113 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

83 services26 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

82 services82 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

68 services45 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

15 services15 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Prov Sacred Hrt Med Ctr & Childs Hosp.

Acute Care Hospitals · Spokane, WA

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number500054

Location101 West 8th AvenueSpokane, WA 99204 · Spokane County

Emergency services Birthing friendly

Providence Holy Family Hospital

Acute Care Hospitals · Spokane, WA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500077

Location5633 North LidgerwoodSpokane, WA 99208 · Spokane County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99216 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

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers24 claims55 services$6.35 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

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

RYAN SAUTHER MD

Internal Medicine