IAN MATTHEW BROUSSARD D.O.
NPI 1871024968
Emergency Medicine in Myrtle Beach, SC

Q: What is Ian Broussard's NPI number?

The NPI number for Ian Broussard is 1871024968. It was assigned to this individual provider in the NPPES registry on March 21, 2017.

Q: What is Ian Broussard's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Ian Broussard was last updated on June 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 March 21, 2017PECOS EnrolledAccepts Medicare Assignment

809 82ND PKWY, GRAND STRAND MEDICAL CENTER GME OFFICE, MYRTLE BEACH, SC 29572(843) 692-1752(843) 692-1904 Get Directions Write a Review

NPPES record last updated: June 12, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 12, 2017, Mar 21, 2017 (2 updates tracked since 2017).

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About Ian Matthew Broussard D.o. NPPES

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

IAN MATTHEW BROUSSARD D.O. (NPI 1871024968) is an individual emergency medicine provider in Myrtle Beach, South Carolina, licensed in South Carolina (LL41064) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS, is affiliated with Ochsner Lafayette General Medical Center, and is a graduate of William Carey University College Of Osteopathic Medicine (2017).

NPPES Registry Identity

NPI1871024968

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameIAN MATTHEW BROUSSARDCredential: D.O.

Location Address809 82ND PKWY, GRAND STRAND MEDICAL CENTER GME OFFICEMyrtle Beach, SC 29572-4607

Mailing Address809 82nd Pkwy, Grand Strand Medical Center Gme OfficeMyrtle Beach, SC 29572-4607 · (843) 692-1752 · Fax (843) 692-1904

Phone(843) 692-1752

Fax(843) 692-1904

Sole ProprietorYes

Medical School CMSWilliam Carey University College Of Osteopathic MedicineGraduated 2017

Enumeration DateMarch 21, 2017

Last NPPES UpdateJune 12, 20172 updates tracked since enumeration

✔ NPI 1871024968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in SC · LL41064

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

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

809 82ND PKWY, Myrtle Beach, SC 29572

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CHRISTUS Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ian Matthew Broussard D.o. 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.

PECOS PAC ID5799058798

PECOS Enrollment IDI20221221000122

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.

Areas of Expertise CMS Part B claims 3

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.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

140 services131 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

57 services53 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

26 services25 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ochsner Lafayette General Medical Center

Acute Care Hospitals · Lafayette, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190002

Location1214 Coolidge AvenueLafayette, LA 70503 · Lafayette County

Emergency services Birthing friendly

Ochsner University Hospital And Clinics

Acute Care Hospitals · Lafayette, LA

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190006

Location2390 West CongressLafayette, LA 70506 · Lafayette County

Emergency services

Acadia General Hospital

Acute Care Hospitals · Crowley, LA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190044

Location1305 Crowley Rayne HighwayCrowley, LA 70526 · Acadia County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29572 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$95.12 typical visit price

range $16.96 – $133.52

Typical copayment $23.78 (range $4.24 – $33.38)

Most-billed visit code 99214

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.

SOUTHEASTERN HOSPITALIST SERVICES PC

Hospitalist