JOHN BRODERICK MD
NPI 1710627070
Psychiatry & Neurology - Psychiatry in Phoenix, AZ

Q: What is John Broderick's NPI number?

The NPI number for John Broderick is 1710627070. It was assigned to this individual provider in the NPPES registry on April 1, 2022.

Q: What is John Broderick's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for John Broderick was last updated on July 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.

Active since April 01, 2022PECOS Enrolled

1919 E THOMAS RD, PHOENIX, AZ 85016(602) 933-1000 Get Directions Write a Review

NPPES record last updated: July 16, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jun 28, 2025, Jun 11, 2025 (2 updates tracked since 2025).

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About John Broderick Md NPPES

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

JOHN BRODERICK MD (NPI 1710627070) is an individual psychiatry provider in Phoenix, Arizona, licensed in Arizona (74541) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1710627070

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameJOHN BRODERICKCredential: MD

Location Address1919 E THOMAS RDPhoenix, AZ 85016-7710

Mailing Address1300 N 12th St Ste 320Phoenix, AZ 85006-2858

Phone(602) 933-1000

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateApril 1, 2022

Last NPPES UpdateJuly 16, 20252 updates tracked since enumeration

NPPES CertifiedJuly 16, 2025

✔ NPI 1710627070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

License✔ Licensed in AZ · 74541

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1919 E THOMAS RD, Phoenix, AZ 85016

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Broderick Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2668966706

PECOS Enrollment IDI20251216000830

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85016 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

$168.60 typical visit price

range $55.44 – $168.60

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

Most-billed visit code 99205

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 20

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

DR. TIMUR RAGHIB M.D.

Hospitalist