1. Home
  2. Directory
  3. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. KEVIN THOMAS BRODERICK LCSW
NPI 1487251864
Social Worker - Clinical in Richford, NY

Active since October 08, 2020PECOS Enrolled
684 OBRIEN HILL RD, RICHFORD, NY 13835(315) 671-8463 Get Directions Write a Review

NPPES record last updated: August 7, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 7, 2026, May 8, 2026, Feb 23, 2022 and 1 more (4 updates tracked since 2020).

About Mr. Kevin Thomas Broderick Lcsw NPPES

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

MR. KEVIN THOMAS BRODERICK LCSW (NPI 1487251864) is an individual clinical provider in Richford, New York, licensed in New York (100984-01) and active in the NPI registry since October 2020. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1487251864
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. KEVIN THOMAS BRODERICKCredential: LCSW
Location Address684 OBRIEN HILL RDRichford, NY 13835-1019
Mailing Address684 Obrien Hill RdRichford, NY 13835-1019 · (315) 412-3625 · Fax (315) 252-3074
Phone(315) 671-8463
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 8, 2020
Last NPPES UpdateAugust 7, 20264 updates tracked since enumeration
NPPES CertifiedAugust 7, 2026
✔ NPI 1487251864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · 100984-01
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.
684 OBRIEN HILL RD, Richford, NY 13835
Open in Google Maps ↗

Secondary Practice Locations 2

Location 17 S Lewis StAuburn, NY 13021-2707 · Phone (315) 412-3625 · Fax (315) 252-3074
Location 2121 North StAuburn, NY 13021-1826 · Phone (315) 252-3074

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kevin Thomas Broderick Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6406336288
PECOS Enrollment IDI20260219002019
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 13835 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 $54.87 – $166.88
Typical copayment $0.00 (range $13.71 – $41.72)
Most-billed visit code NA
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
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.

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 Kevin Broderick's NPI number?

The NPI number for Kevin Broderick is 1487251864. It was assigned to this individual provider in the NPPES registry on October 8, 2020.

Where is Kevin Broderick located?

Kevin Broderick practices at 684 Obrien Hill Rd, Richford, NY 13835. The listed phone number is (315) 671-8463.

What is Kevin Broderick's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kevin Broderick enrolled in Medicare?

Yes. Kevin Broderick is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kevin Broderick was last updated on August 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days 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.