MR. KELLY G BRODERSON
NPI 1467702746
Social Worker - Clinical in Lexington, KY
About Mr. Kelly G Broderson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. KELLY G BRODERSON (NPI 1467702746) is an individual clinical provider in Lexington, Kentucky, licensed in Kentucky (3992) and active in the NPI registry since September 2012. He is enrolled in Medicare PECOS and is a graduate of Other (2012).
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Kelly G Broderson 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.
Medicare Billing Reassignment
Medicare enrollment records show Kelly Broderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lexington, KY 40507
- Reassigned Medicare billing, Kentucky enrollment
- 1,761 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 40509 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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 Kelly Broderson's NPI number?
The NPI number for Kelly Broderson is 1467702746. It was assigned to this individual provider in the NPPES registry on September 14, 2012.
Where is Kelly Broderson located?
Kelly Broderson practices at 245 Fountain Ct Ste 316, Lexington, KY 40509. The listed phone number is (859) 257-9210.
What is Kelly Broderson's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Kelly Broderson enrolled in Medicare?
Yes. Kelly Broderson 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.
Which organization bills Medicare for Kelly Broderson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Broderson reassigns Medicare benefits to University Of Kentucky (Lexington, KY). 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 Kelly Broderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Broderson accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Kelly Broderson 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 Kelly Broderson was last updated on May 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Mr. Kelly G Broderson · NPI 1467702746
Clinical provider in Lexington, Kentucky. Individual provider, active in the CMS NPPES registry since September 14, 2012.
## Identity
- **NPI:** 1467702746 (Entity type: Individual)
- **Enumerated:** September 14, 2012
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 3992 (Kentucky)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 245 FOUNTAIN CT STE 316, Lexington, KY 40509-1888
- **Phone:** (859) 257-9210
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** University Of Kentucky (NPI 1881641769, Lexington, KY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2012
## Record status
- **NPPES last updated:** May 9, 2019
- **Other identifiers:** Medicaid 1790731081 (KY)
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Source: [NPI Profile](https://npiprofile.com/npi/1467702746) · Data from the CMS NPPES public registry.