MALCOLM L BROADNAX
NPI 1457193278
Counselor - Addiction (Substance Use Disorder) in Nottingham, MD
About Malcolm L Broadnax NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MALCOLM L BROADNAX (NPI 1457193278) is an individual addiction (substance use disorder) provider in Nottingham, Maryland, licensed in Maryland (LCA3486) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Malcolm L Broadnax is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Malcolm Broadnax reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Nottingham, MD 21236
- Reassigned Medicare billing, Maryland enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NOTTINGHAM, MD 21236
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 Malcolm Broadnax's NPI number?
The NPI number for Malcolm Broadnax is 1457193278. It was assigned to this individual provider in the NPPES registry on June 11, 2024.
Where is Malcolm Broadnax located?
Malcolm Broadnax practices at 4412 Cole Farm Rd, Nottingham, MD 21236. The listed phone number is (443) 528-0822.
What is Malcolm Broadnax's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.
Is Malcolm Broadnax enrolled in Medicare?
Yes. Malcolm Broadnax is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Malcolm Broadnax's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Malcolm Broadnax reassigns Medicare benefits to Awake & Rooted Wellness & Recovery, LLC (Nottingham, MD). 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 Malcolm Broadnax'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 Malcolm Broadnax was last updated on June 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Malcolm L Broadnax · NPI 1457193278
Addiction (Substance Use Disorder) provider in Nottingham, Maryland. Individual provider, active in the CMS NPPES registry since June 11, 2024.
## Identity
- **NPI:** 1457193278 (Entity type: Individual)
- **Enumerated:** June 11, 2024
- **Primary specialty:** Counselor - Addiction (Substance Use Disorder) · taxonomy 101YA0400X
- **State license:** LCA3486 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 4412 COLE FARM RD, Nottingham, MD 21236-2961
- **Phone:** (443) 528-0822
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Awake & Rooted Wellness & Recovery, LLC (NPI 1407740582, Nottingham, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1457193278) · Data from the CMS NPPES public registry.