DR. ANDRE EDMOND BROUSSARD M.D.
NPI 1710069695
Pediatrics - Sports Medicine in New York, NY
NPI Status: Active since October 19, 2006
Contact Information
1901 FIRST AVE
523
NEW YORK, NY
ZIP 10029
Phone: (212) 423-6228
Fax: (212) 534-7831
- Individual
- Male
- Pediatrics
- Sports Medicine
- PECOS Enrolled
About ANDRE BROUSSARD
This page provides the complete NPI Profile along with additional information for Andre Broussard, a pediatrician established in New York, New York with a medical specialization in Pediatrics, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1710069695 assigned on October 2006. The practitioner's primary taxonomy code is 2080S0010X with license number MD126425 (NY). The provider is registered as an individual and his NPI record was last updated 19 years ago.
- NPI
- 1710069695
- Provider Name
- DR. ANDRE EDMOND BROUSSARD M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1901 FIRST AVE 523 NEW YORK, NY 10029
- Location Phone
- (212) 423-6228
- Location Fax
- (212) 534-7831
- Mailing Address
- 1901 1ST AVE ROOM 523 NEW YORK, NY 10029
- Mailing Phone
- (212) 423-6228
- Mailing Fax
- (212) 534-7831
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 10-19-2006
- Last Update Date
- 11-29-2007
- Code Navigator
A pediatrician like Andre Broussard is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Sports Medicine
- Taxonomy Code
- 2080S0010X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD126425
- License State
- NY
- Taxonomy Description
- A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| C07074 | MEDICARE UPIN (02) | NY |
Medicare Participation & PECOS Enrollment Status
Andre Broussard is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710069695, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
NEW YORK, NY 10029
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710069695, enumerated as an "individual" on October 19, 2006.
The provider is located at 1901 FIRST AVE 523 NEW YORK, NY 10029 and the phone number is (212) 423-6228.
Pediatrics with taxonomy code 2080S0010X and a focus in Sports Medicine.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
