KEVIN STANLEY BROADDRICK DPM
NPI 1639188394
Podiatrist in Peoria, AZ

Q: What is Kevin Broaddrick's NPI number?

The NPI number for Kevin Broaddrick is 1639188394. It was assigned to this individual provider in the NPPES registry on August 5, 2006.

Q: What is Kevin Broaddrick's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Broaddrick was last updated on August 11, 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.

Active since August 05, 2006PECOS Enrolled

6739 W CACTUS RD, PEORIA, AZ 85381(833) 242-0100(602) 805-4745 Get Directions Write a Review

NPPES record last updated: August 11, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Kevin Stanley Broaddrick Dpm NPPES

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

KEVIN STANLEY BROADDRICK DPM (NPI 1639188394) is an individual podiatrist in Peoria, Arizona, licensed in Arizona (POD-000814) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639188394

Entity TypeIndividualMale

Primary Taxonomy213E00000X

Provider Legal NameKEVIN STANLEY BROADDRICKCredential: DPM

Location Address6739 W CACTUS RDPeoria, AZ 85381-5311

Mailing Address3149 E Hazeltine WayChandler, AZ 85249-9066 · (414) 702-0954

Phone(833) 242-0100

Fax(602) 805-4745

Sole ProprietorYes

Enumeration DateAugust 5, 2006

Last NPPES UpdateAugust 11, 2023

NPPES CertifiedAugust 11, 2023

✔ NPI 1639188394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers

Taxonomy Code213E00000X

License✔ Licensed in AZ · POD-000814

Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

6739 W CACTUS RD, Peoria, AZ 85381

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kevin Stanley Broaddrick Dpm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

Medicare enrollment records show Kevin Broaddrick reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Angels Valley Community Healthcare Center PLLC

10 mi

Physician Assistant

14820 N CAVE CREEK RD STE 2
Phoenix, AZ 85032

Reassigned Medicare billing, Arizona enrollment
28 clinicians in this Medicare group

NPI 1689303117 (833) 242-0100

Active Vital Care LLC

11 mi

Family Medicine

1928 E HIGHLAND AVE STE F104
Phoenix, AZ 85016

Reassigned Medicare billing, Arizona enrollment
33 clinicians in this Medicare group

NPI 1326825092 (833) 242-0100

Agave Adult Medical Care LLC

86 mi

Adult Medicine

70 BELL ROCK PLZ STE C
Sedona, AZ 86351

Reassigned Medicare billing, Arizona enrollment
15 clinicians in this Medicare group

NPI 1861153579 (315) 717-7898

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.

Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes 99348

An established patient home visit is a 25-minute appointment where a healthcare provider visits you at your home. This service is for patients who have previously been seen by the provider. It includes a check-up and discussion about your health concerns.

317 services142 patients

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

315 services140 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85381 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

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.

Other Providers at the Same Location NPPES 14

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

ARIZONA DOCTORS, LLC

Family Medicine