BROAD RIVER AREA MEDICAL AND AESTHETICS
NPI 1568407534
Physician Assistant in Cliffside, NC
About Broad River Area Medical And Aesthetics NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BROAD RIVER AREA MEDICAL AND AESTHETICS (NPI 1568407534) is a healthcare organization registered as a physician assistant in Cliffside, North Carolina and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through October 12, 2027 and lists Timothy D. Green, Owner/pa, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Broad River Area Medical And Aesthetics is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Broad River Area Medical And Aesthetics, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 34D1000526
Broad River Area Medical & Aesthetics LLC · Cliffside, NCFrequently 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 Broad River Area Medical And Aesthetics's NPI number?
The NPI number for Broad River Area Medical And Aesthetics is 1568407534. It was assigned to this organization in the NPPES registry on June 16, 2006.
Where is Broad River Area Medical And Aesthetics located?
Broad River Area Medical And Aesthetics is located at 245 Old Main Street, Cliffside, NC 28024. The listed phone number is (828) 657-5722.
What is Broad River Area Medical And Aesthetics's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Broad River Area Medical And Aesthetics enrolled in Medicare?
Yes. Broad River Area Medical And Aesthetics is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Broad River Area Medical And Aesthetics?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pulmonary Disease) reassigns their Medicare billing to Broad River Area Medical And Aesthetics. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Broad River Area Medical And Aesthetics hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D1000526) is associated with this NPI, valid through October 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Broad River Area Medical And Aesthetics accept?
Health plans from Blue Cross and Blue Shield of NC list Broad River Area Medical And Aesthetics 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 Broad River Area Medical And Aesthetics was last updated on February 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Broad River Area Medical And Aesthetics · NPI 1568407534
Physician Assistant organization in Cliffside, North Carolina. Organization record, active in the CMS NPPES registry since June 16, 2006.
## Identity
- **NPI:** 1568407534 (Entity type: Organization)
- **Enumerated:** June 16, 2006
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **Organization subpart:** No
- **Authorized official:** Timothy Green, OWNER/PA
## Practice location
- **Address:** 245 OLD MAIN STREET, Cliffside, NC 28024-0275
- **Phone:** (828) 657-5722 · **Fax:** (828) 657-5738
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Pulmonary Disease) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 4, 2026
- **Other identifiers:** Other 1177X; Medicaid 891177X (NC)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1568407534) · Data from the CMS NPPES public registry.