BENJAMIN I. BRODER MD
NPI 1902977812
Family Medicine in Baldwin Park, CA
About Benjamin I. Broder Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BENJAMIN I. BRODER MD (NPI 1902977812) is an individual family medicine provider in Baldwin Park, California, licensed in California (G84784) and active in the NPI registry since November 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Benjamin I. Broder Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Benjamin Broder reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Baldwin Park, CA 91706
- Reassigned Medicare billing, California enrollment
- 13,921 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 91706 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
BALDWIN PARK, CA 91706
BALDWIN PARK, CA 91706
BALDWIN PARK, CA 91706
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 Benjamin Broder's NPI number?
The NPI number for Benjamin Broder is 1902977812. It was assigned to this individual provider in the NPPES registry on November 13, 2006.
Where is Benjamin Broder located?
Benjamin Broder practices at 1011 Baldwin Park Blvd, Baldwin Park, CA 91706. The listed phone number is (626) 851-1011.
What is Benjamin Broder's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Benjamin Broder enrolled in Medicare?
Yes. Benjamin Broder is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Benjamin Broder's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Benjamin Broder reassigns Medicare benefits to Southern California Permanente Medical Group (Baldwin Park, CA). 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 Benjamin Broder's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Benjamin Broder was last updated on February 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Benjamin I. Broder, MD · NPI 1902977812
Family Medicine physician in Baldwin Park, California. Individual provider, active in the CMS NPPES registry since November 13, 2006.
## Identity
- **NPI:** 1902977812 (Entity type: Individual)
- **Enumerated:** November 13, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** G84784 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1011 BALDWIN PARK BLVD, Baldwin Park, CA 91706-5806
- **Phone:** (626) 851-1011
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1770515280, Baldwin Park, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 7, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1902977812) · Data from the CMS NPPES public registry.