REBECCA BRODERICK ACNPC-AG, BSN, RN
NPI 1629755657
Nurse Practitioner in Lacey, WA

Active since June 30, 2023PECOS EnrolledAccepts Medicare Assignment
677 WOODLAND SQUARE LOOP SE STE D7, LACEY, WA 98503(703) 447-6155 Get Directions Write a Review

NPPES record last updated: June 30, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Rebecca Broderick Acnpc-ag, Bsn, Rn NPPES

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

REBECCA BRODERICK ACNPC-AG, BSN, RN (NPI 1629755657) is an individual nurse practitioner in Lacey, Washington, licensed in Washington (61413663-NP) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS, is affiliated with Providence St Peter Hospital, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1629755657
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameREBECCA BRODERICKCredential: ACNPC-AG, BSN, RN
Location Address677 WOODLAND SQUARE LOOP SE STE D7Lacey, WA 98503-1000
Mailing Address18824 Mountain Point DrEagle River, AK 99577-8555 · (703) 447-6155
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJune 30, 2023
NPPES CertifiedJune 30, 2023
NPI 1629755657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License Licensed in WA · 61413663-NP
Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

677 WOODLAND SQUARE LOOP SE STE D7, Lacey, WA 98503

Other Names 1

Former Name (1)Rebecca Broderick Holmes

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

Rebecca Broderick Acnpc-ag, Bsn, Rn 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 ID244676575
PECOS Enrollment IDI20240308003642
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence St Peter Hospital

Acute Care Hospitals · Olympia, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500024
Location413 Lilly Road NEOlympia, WA 98506 · Thurston County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98503 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
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.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1629755657, enumerated as an "individual" on June 30, 2023.

The provider is located at 677 WOODLAND SQUARE LOOP SE STE D7 LACEY, WA 98503 and the phone number is (703) 447-6155.

Nurse Practitioner with taxonomy code 363L00000X.

The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska. Please consult your insurance carrier or call the provider to verify.

Rebecca Broderick is affiliated with: PROVIDENCE ST PETER HOSPITAL.