THOMAS W BRODERICK M.D.
NPI 1407878853
Radiology - Diagnostic Radiology in Boise, ID

Q: What is Thomas Broderick's NPI number?

The NPI number for Thomas Broderick is 1407878853. It was assigned to this individual provider in the NPPES registry on July 24, 2006.

Q: What is Thomas Broderick's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Broderick was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since July 24, 2006PECOS Enrolled

190 E BANNOCK ST, BOISE, ID 83712(208) 381-2094 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Thomas W Broderick M.d. NPPES

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

THOMAS W BRODERICK M.D. (NPI 1407878853) is an individual diagnostic radiology provider in Boise, Idaho, licensed in Idaho (M6258) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407878853

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameTHOMAS W BRODERICKCredential: M.D.

Location Address190 E BANNOCK STBoise, ID 83712-6241

Mailing AddressPo Box 9696Boise, ID 83707-4696 · (208) 472-8118 · Fax (208) 344-1926

Phone(208) 381-2094

Sole ProprietorNo

Enumeration DateJuly 24, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1407878853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in ID · M6258

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

190 E BANNOCK ST, Boise, ID 83712

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Other Identifiers 3

Medicare UPINA45059

Medicare ID-Type Unspecified1100321ID

Medicare ID-Type Unspecified1100320ID

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Thomas W Broderick M.d. 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 83712 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$65.77 typical visit price

range $16.68 – $130.93

Typical copayment $16.44 (range $4.17 – $32.73)

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.

NORA M SUAREZ NP

Nurse Practitioner (Neonatal, Critical Care)