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AMANDA V BRODERICK PHD
NPI 1720752553
Psychologist - Cognitive & Behavioral in Indianapolis, IN

Active since August 05, 2021PECOS Enrolled
1002 WISHARD BLVD STE 4110, INDIANAPOLIS, IN 46202(317) 944-8162(317) 948-4848 Get Directions Write a Review

NPPES record last updated: May 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 19, 2025, May 19, 2022, Dec 14, 2021 and 1 more (4 updates tracked since 2021).

About Amanda V Broderick Phd NPPES

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

AMANDA V BRODERICK PHD (NPI 1720752553) is an individual cognitive & behavioral provider in Indianapolis, Indiana, licensed in Indiana (20043498A) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1720752553
Entity TypeIndividualFemale
Primary Taxonomy103TB0200X
Provider Legal NameAMANDA V BRODERICKCredential: PHD
Location Address1002 WISHARD BLVD STE 4110Indianapolis, IN 46202-4164
Mailing Address250 N Shadeland AveIndianapolis, IN 46219-4959
Phone(317) 944-8162
Fax(317) 948-4848
Sole ProprietorNo
Enumeration DateAugust 5, 2021
Last NPPES UpdateMay 19, 20254 updates tracked since enumeration
NPPES CertifiedMay 19, 2025
✔ NPI 1720752553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · Cognitive & BehavioralBehavioral Health & Social Service Providers
Taxonomy Code103TB0200X
License✔ Licensed in IN · 20043498A
Definition
A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.
Also ListedPsychologistTaxonomy 103T00000X · License 20043498A (IN)
1002 WISHARD BLVD STE 4110, Indianapolis, IN 46202
Open in Google Maps ↗

Secondary Practice Location 1

Location 11701 N Senate BlvdIndianapolis, IN 46202-1239 · Phone (888) 484-3258

Other Identifiers 1

Medicaid300054677IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda V Broderick Phd 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

3

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

Iu Health Medical Group Riley Specialists, LLC
0.2 mi
Pediatrics
705 RILEY HOSPITAL DR
Indianapolis, IN 46202
  • Reassigned Medicare billing, Indiana enrollment
  • 523 clinicians in this Medicare group
NPI 1699561480 (317) 944-5000
Indiana University Health Care Associates, Inc
0.7 mi
General Practice
340 W TENTH ST
Indianapolis, IN 46202
  • Reassigned Medicare billing, Indiana enrollment
  • 1,781 clinicians in this Medicare group
NPI 1902032832 (317) 278-3505
Iu Health Medical Group, LLC
1.1 mi
General Practice
1701 N SENATE BLVD
Indianapolis, IN 46202
  • Reassigned Medicare billing, Indiana enrollment
  • 5,212 clinicians in this Medicare group
NPI 1326893777 (317) 962-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

JANISE LORRAINE WINSTON LMHC
Counselor (Mental Health)
1002 WISHARD BLVD STE 4110
INDIANAPOLIS, IN 46202
Marion County (317) 944-8162
DARRIN RAY MCCLURE LCSW
Social Worker (Clinical)
1002 WISHARD BLVD STE 4110
INDIANAPOLIS, IN 46202
Marion County (317) 358-7564
CAILIN COLEMAN LCSW
Social Worker (Clinical)
1002 WISHARD BLVD STE 4110
INDIANAPOLIS, IN 46202
Marion County (463) 246-2065
BRIGID R MARRIOTT PHD
Psychologist (Clinical)
1002 WISHARD BLVD STE 4110
INDIANAPOLIS, IN 46202
Marion County (317) 944-8162
JANET LYDECKER PHD
Psychologist (Clinical)
1002 WISHARD BLVD STE 4110
INDIANAPOLIS, IN 46202
Marion County (317) 944-8162
DR. ELIZABETH ANN LINXWILER DO
Psychiatry & Neurology (Child & Adolescent Psychiatry)
1002 WISHARD BLVD STE 4110
INDIANAPOLIS, IN 46202
Marion County (317) 944-8162
ZACHARY W ADAMS PHD
Psychologist (Clinical)
1002 WISHARD BLVD STE 4110
INDIANAPOLIS, IN 46202
Marion County (317) 963-7391
ERIN TULLY LMHC
Counselor (Mental Health)
1002 WISHARD BLVD STE 4110
INDIANAPOLIS, IN 46202
Marion County (317) 944-8162

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 Amanda Broderick's NPI number?

The NPI number for Amanda Broderick is 1720752553. It was assigned to this individual provider in the NPPES registry on August 5, 2021.

Where is Amanda Broderick located?

Amanda Broderick practices at 1002 Wishard Blvd Ste 4110, Indianapolis, IN 46202. The listed phone number is (317) 944-8162.

What is Amanda Broderick's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.

Is Amanda Broderick enrolled in Medicare?

Yes. Amanda Broderick is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Amanda Broderick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amanda Broderick reassigns Medicare benefits to 3 organizations: Iu Health Medical Group Riley Specialists, LLC (Indianapolis, IN), Indiana University Health Care Associates, Inc (Indianapolis, IN) and Iu Health Medical Group, LLC (Indianapolis, IN). 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 Amanda Broderick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amanda Broderick accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and UnitedHealthcare list Amanda 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.

When was this NPI record last updated?

The NPPES record for Amanda Broderick was last updated on May 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.