KATELYN BROUSSARD
NPI 1962278234
Nurse Anesthetist, Certified Registered in Philadelphia, PA

Active since November 28, 2023Accepts Medicare Assignment
3400 SPRUCE ST, PHILADELPHIA, PA 19104(800) 789-7366 Get Directions Write a Review

NPPES record last updated: November 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Katelyn Broussard NPPES

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

KATELYN BROUSSARD (NPI 1962278234) is an individual nurse anesthetist, certified registered in Philadelphia, Pennsylvania, licensed in Pennsylvania (26NR227227100) and active in the NPI registry since November 2023. She is affiliated with Hospital Of Univ Of Pennsylvania and is a graduate of Other (2023).

NPPES Registry Identity

NPI1962278234
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameKATELYN BROUSSARD
Location Address3400 SPRUCE STPhiladelphia, PA 19104-4238
Mailing Address615 Miller StPhiladelphia, PA 19125-2721 · (443) 610-8755
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateNovember 28, 2023
NPPES CertifiedNovember 28, 2023
NPI 1962278234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License Licensed in PA · 26NR227227100
Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

3400 SPRUCE ST, Philadelphia, PA 19104

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

Katelyn Broussard 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 ID3577904416
PECOS Enrollment IDI20240509002840

Hospital Affiliations CMS Care Compare 2

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

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390111
Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County
Emergency services Birthing friendly

Penn Presbyterian Medical Center

Acute Care Hospitals · Philadelphia, PA
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390223
Location51 North 39th StreetPhiladelphia, PA 19104 · Philadelphia County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
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.

Anesthesiology
3400 SPRUCE ST, 6 DULLES
PHILADELPHIA, PA 19104
Anesthesiology (Pain Medicine)
3400 SPRUCE ST, HUP-DULLES 6, ANESTHESIOLOGY DEPT
PHILADELPHIA, PA 19104
Genetic Counselor, MS
3400 SPRUCE ST, 535 MALONEY BLDG
PHILADELPHIA, PA 19104
Genetic Counselor, MS
3400 SPRUCE ST, 2007 PENN TOWER
PHILADELPHIA, PA 19104
Nurse Practitioner (Adult Health)
3400 SPRUCE ST, GOUND FLOOR SILVERSTEIN
PHILADELPHIA, PA 19104
Genetic Counselor, MS
3400 SPRUCE ST, ROOM 538 MALONEY BUILDING
PHILADELPHIA, PA 19104
Radiology (Radiation Oncology)
3400 SPRUCE ST
PHILADELPHIA, PA 19104
Psychiatry & Neurology (Psychiatry)
3400 SPRUCE ST, 2016 PENN TOWER
PHILADELPHIA, PA 19104

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962278234, enumerated as an "individual" on November 28, 2023.

The provider is located at 3400 SPRUCE ST PHILADELPHIA, PA 19104 and the phone number is (800) 789-7366.

Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Katelyn Broussard is affiliated with: HOSPITAL OF UNIV OF PENNSYLVANIA and PENN PRESBYTERIAN MEDICAL CENTER.