JUSTINE A BROECKER M.D.
NPI 1740713221
Surgery in Jacksonville, FL
About Justine A Broecker M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JUSTINE A BROECKER M.D. (NPI 1740713221) is an individual surgery provider in Jacksonville, Florida, licensed in Florida (ME141738) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS, is affiliated with Gallup Indian Medical Center, and maintains a secondary practice location in Atlanta.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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
Justine A Broecker M.d. 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 Reassignment
Medicare enrollment records show Justine Broecker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Gallup, NM 87301
- Reassigned Medicare billing, Texas enrollment
- 618 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Gallup Indian Medical Center
Acute Care Hospitals · Gallup, NMPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32224 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
JACKSONVILLE, FL 32224
JACKSONVILLE, FL 32224
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 Justine Broecker's NPI number?
The NPI number for Justine Broecker is 1740713221. It was assigned to this individual provider in the NPPES registry on April 11, 2017.
Where is Justine Broecker located?
Justine Broecker practices at 4500 San Pablo Rd S, Jacksonville, FL 32224. The listed phone number is (904) 953-2000.
What is Justine Broecker's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Justine Broecker enrolled in Medicare?
Yes. Justine Broecker 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 organization bills Medicare for Justine Broecker's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Justine Broecker reassigns Medicare benefits to Dhhs,phs,naihs,gallup Indian Medical Center (Gallup, NM). The 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 Justine Broecker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Justine Broecker affiliated with any hospitals?
According to CMS data, Justine Broecker is affiliated with Gallup Indian Medical Center.
When was this NPI record last updated?
The NPPES record for Justine Broecker was last updated on September 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Justine A Broecker, M.D. · NPI 1740713221
Surgery physician in Jacksonville, Florida. Individual provider, active in the CMS NPPES registry since April 11, 2017.
## Identity
- **NPI:** 1740713221 (Entity type: Individual)
- **Enumerated:** April 11, 2017
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** ME141738 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 4500 SAN PABLO RD S, Jacksonville, FL 32224-1865
- **Phone:** (904) 953-2000
## 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:** Dhhs,phs,naihs,gallup Indian Medical Center (NPI 1245409960, Gallup, NM), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Emory University School Of Medicine, class of 2017
## Record status
- **NPPES last updated:** September 2, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1740713221) · Data from the CMS NPPES public registry.