GRACE CHANG BRODERICK M.D.
NPI 1548525264
Internal Medicine in Tustin, CA

Q: What is Grace Chang Broderick's NPI number?

The NPI number for Grace Chang Broderick is 1548525264. It was assigned to this individual provider in the NPPES registry on July 9, 2012.

Q: What is Grace Chang Broderick's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since July 09, 2012PECOS EnrolledAccepts Medicare Assignment

2521 MICHELLE DR, TUSTIN, CA 92780(888) 988-2800 Get Directions Write a Review

NPPES record last updated: November 22, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Grace Chang Broderick M.d. NPPES

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

GRACE CHANG BRODERICK M.D. (NPI 1548525264) is an individual internal medicine provider in Tustin, California, licensed in California (135716) and active in the NPI registry since July 2012. She is enrolled in Medicare PECOS and is a graduate of Geisel School Of Medicine At Dartmouth (2012).

NPPES Registry Identity

NPI1548525264

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameGRACE CHANG BRODERICKCredential: M.D.

Location Address2521 MICHELLE DRTustin, CA 92780-7014

Mailing Address2521 Michelle DrTustin, CA 92780-7014

Phone(888) 988-2800

Sole ProprietorNo

Medical School CMSGeisel School Of Medicine At DartmouthGraduated 2012

Enumeration DateJuly 9, 2012

Last NPPES UpdateNovember 22, 2021

✔ NPI 1548525264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · 135716

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2521 MICHELLE DR, Tustin, CA 92780

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota.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

Grace Chang Broderick M.d. 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 ID749590347

PECOS Enrollment IDI20151111001666

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.

Medicare Billing Reassignment

Medicare enrollment records show Grace Chang Broderick reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group

9.1 mi

Health Maintenance Organization

441 N LAKEVIEW AVE
Anaheim, CA 92807

Reassigned Medicare billing, California enrollment
13,921 clinicians in this Medicare group

NPI 1952333460 (714) 279-4000

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 92780 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

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

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 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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