KATELYN BROUSSARD
NPI 1962278234
Nurse Anesthetist, Certified Registered in Philadelphia, PA
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
Specialties & Licenses
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
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.
Medicare Billing Reassignment
Medicare enrollment records show Katelyn Broussard reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Philadelphia, PA 19104
- Reassigned Medicare billing, Pennsylvania enrollment
- 3,488 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 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, PAPenn Presbyterian Medical Center
Acute Care Hospitals · Philadelphia, PAPhysician 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.
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.
PHILADELPHIA, PA 19104
PHILADELPHIA, PA 19104
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 Katelyn Broussard's NPI number?
The NPI number for Katelyn Broussard is 1962278234. It was assigned to this individual provider in the NPPES registry on November 28, 2023.
Where is Katelyn Broussard located?
Katelyn Broussard practices at 3400 Spruce St, Philadelphia, PA 19104. The listed phone number is (800) 789-7366.
What is Katelyn Broussard's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Katelyn Broussard enrolled in Medicare?
Yes. Katelyn Broussard 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 Katelyn Broussard's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Katelyn Broussard reassigns Medicare benefits to University Of Penn-Medical Group (Philadelphia, PA). 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 Katelyn Broussard's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Katelyn Broussard affiliated with any hospitals?
According to CMS data, Katelyn Broussard is affiliated with Hospital Of Univ Of Pennsylvania and Penn Presbyterian Medical Center.
When was this NPI record last updated?
The NPPES record for Katelyn Broussard was last updated on November 28, 2023. 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.
# Katelyn Broussard · NPI 1962278234
Nurse Anesthetist, Certified Registered physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since November 28, 2023.
## Identity
- **NPI:** 1962278234 (Entity type: Individual)
- **Enumerated:** November 28, 2023
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 26NR227227100 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 3400 SPRUCE ST, Philadelphia, PA 19104-4238
- **Phone:** (800) 789-7366
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** University Of Penn-Medical Group (NPI 1073902169, Philadelphia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** November 28, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1962278234) · Data from the CMS NPPES public registry.