WEST BROADWAY CLINIC, PC
NPI 1407031230
Internal Medicine in Council Bluffs, IA
About West Broadway Clinic, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WEST BROADWAY CLINIC, PC (NPI 1407031230) is a healthcare organization registered as an internal medicine in Council Bluffs, Iowa and active in the NPI registry since December 2007. The organization holds a CLIA Waiver certificate valid through May 19, 2028 and lists Isam Elias Marar, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
West Broadway Clinic, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to West Broadway Clinic, PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 16D1084332
West Broadway Clinic, PC · Council Bluffs, IAFrequently 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 West Broadway Clinic, PC's NPI number?
The NPI number for West Broadway Clinic, PC is 1407031230. It was assigned to this organization in the NPPES registry on December 28, 2007.
Where is West Broadway Clinic, PC located?
West Broadway Clinic, PC is located at 16 S 17th St, Council Bluffs, IA 51501. The listed phone number is (712) 256-5600.
What is West Broadway Clinic, PC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is West Broadway Clinic, PC enrolled in Medicare?
Yes. West Broadway Clinic, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through West Broadway Clinic, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to West Broadway Clinic, PC. A 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 the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does West Broadway Clinic, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 16D1084332) is associated with this NPI, valid through May 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does West Broadway Clinic, PC accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Nebraska list West Broadway Clinic, PC 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 West Broadway Clinic, PC was last updated on December 28, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# West Broadway Clinic, Pc · NPI 1407031230
Internal Medicine organization in Council Bluffs, Iowa. Organization record, active in the CMS NPPES registry since December 28, 2007.
## Identity
- **NPI:** 1407031230 (Entity type: Organization)
- **Enumerated:** December 28, 2007
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Isam Marar, PRESIDENT
## Practice location
- **Address:** 16 S 17TH ST, Council Bluffs, IA 51501-3818
- **Phone:** (712) 256-5600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 28, 2007
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1407031230) · Data from the CMS NPPES public registry.