REBECCA BRODERICK ACNPC-AG, BSN, RN
NPI 1629755657
Nurse Practitioner in Lacey, WA
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
Specialties & Licenses
Other Names 1
Accepted 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
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.
Medicare Billing Reassignments
2Medicare enrollment records show Rebecca Broderick reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Lacey, WA 98503
- Reassigned Medicare billing, Washington enrollment
- 184 clinicians in this Medicare group
Centralia, WA 98531
- Reassigned Medicare billing, Washington enrollment
- 85 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
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, WAPhysician 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.
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 Rebecca Broderick's NPI number?
The NPI number for Rebecca Broderick is 1629755657. It was assigned to this individual provider in the NPPES registry on June 30, 2023. The provider is also known as Rebecca Broderick Holmes.
Where is Rebecca Broderick located?
Rebecca Broderick practices at 677 Woodland Square Loop SE Ste D7, Lacey, WA 98503. The listed phone number is (703) 447-6155.
What is Rebecca Broderick's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Rebecca Broderick enrolled in Medicare?
Yes. Rebecca Broderick 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.
Which organizations bill Medicare for Rebecca Broderick's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Rebecca Broderick reassigns Medicare benefits to 2 organizations: Providence Health & Services Washington (Lacey, WA) and Providence Health & Services Washington (Centralia, WA). Each 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 Rebecca Broderick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Rebecca Broderick accept?
Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Rebecca Broderick 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.
Is Rebecca Broderick affiliated with any hospitals?
According to CMS data, Rebecca Broderick is affiliated with Providence St Peter Hospital.
When was this NPI record last updated?
The NPPES record for Rebecca Broderick was last updated on June 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Rebecca Broderick, ACNPC-AG, BSN, RN · NPI 1629755657
Nurse Practitioner physician in Lacey, Washington. Individual provider, active in the CMS NPPES registry since June 30, 2023.
## Identity
- **NPI:** 1629755657 (Entity type: Individual)
- **Enumerated:** June 30, 2023
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 61413663-NP (Washington)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 677 WOODLAND SQUARE LOOP SE STE D7, Lacey, WA 98503-1000
- **Phone:** (703) 447-6155
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Providence Health & Services Washington (NPI 1063611408, Lacey, WA); Providence Health & Services Washington (NPI 1275732661, Centralia, WA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** June 30, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1629755657) · Data from the CMS NPPES public registry.