MR. KELLY G BRODERSON
NPI 1467702746
Social Worker - Clinical in Lexington, KY

Active since September 14, 2012PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
245 FOUNTAIN CT STE 316, LEXINGTON, KY 40509(859) 257-9210 Get Directions Write a Review

NPPES record last updated: May 9, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 9, 2019, Mar 3, 2016 (2 updates tracked since 2016).

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

NPI1467702746
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. KELLY G BRODERSON
Location Address245 FOUNTAIN CT STE 316Lexington, KY 40509-1888
Mailing Address245 Fountain Ct Ste 225Lexington, KY 40509-1888 · (859) 323-6021
Sole ProprietorYes
Medical School CMSOtherGraduated 2012
Enumeration DateSeptember 14, 2012
Last NPPES UpdateMay 9, 20192 updates tracked since enumeration
NPI 1467702746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in KY · 3992
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X · License 6364 (KY)
245 FOUNTAIN CT STE 316, Lexington, KY 40509

Other Identifiers 1

Medicaid1790731081KY

Accepted 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

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.

PECOS PAC ID2466763248
PECOS Enrollment IDI20150619001564
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 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.

New Patient
$0.00 typical visit price
range $52.76 – $162.27
Typical copayment $0.00 (range $13.19 – $40.56)
Most-billed visit code NA
Established Patient
$66.24 typical visit price
range $16.53 – $131.99
Typical copayment $16.56 (range $4.13 – $32.99)
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.

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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability100
Improvement Activities40

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.

What insurance does Kelly Broderson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and Blue Cross and Blue Shield of Texas 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.