| Cari Broderick, PA-C | |
|
14534 Old Saint Augustine Rd Ste 3210, Jacksonville, FL 32258-2645 | |
| (904) 675-4000 | |
| (904) 675-4007 |
| Full Name | Cari Broderick |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 6 Years |
| Location | 14534 Old Saint Augustine Rd Ste 3210, Jacksonville, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609495936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9113167 (Florida) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | PA9113167 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension St Vincent's Clay County | Middleburg, FL | Hospital |
| Ascension St Vincent's Riverside | Jacksonville, FL | Hospital |
| Baptist Medical Center Jacksonville | Jacksonville, FL | Hospital |
| Brooks Rehabilitation Hospital University Campus | Jacksonville, FL | Inpatient rehabilitation facility |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| First Coast Surgical Associates Inc. | 5395779359 | 31 |
| Cora Health Services Inc | 1759290992 | 1125 |
| Cora Health Services Inc | 1759290992 | 1125 |
| Entity Name | Southeast Orthopedic Specialists LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629025820 PECOS PAC ID: 1456246974 Enrollment ID: O20040216000301 |
| Entity Name | First Coast Surgical Associates Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548249543 PECOS PAC ID: 5395779359 Enrollment ID: O20070109000450 |
| Mailing Address | Practice Location Address |
|---|---|
| Cari Broderick, PA-C 11945 San Jose Blvd Ste 300, Jacksonville, FL 32223-1627 Ph: (904) 396-1725 | Cari Broderick, PA-C 14534 Old Saint Augustine Rd Ste 3210, Jacksonville, FL 32258-2645 Ph: (904) 675-4000 |
Katherine L Walsh, PA-C/MPH Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |
Teresa Louise Cowan, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1200 Riverplace Blvd, Suite 620, Jacksonville, FL 32207 Phone: 904-396-6620 Fax: 904-396-6528 |
Mrs. Melina Volner Sommese, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2594 Fax: 904-953-6225 |
Jessica Defazio, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 836 Prudential Dr Ste 1400, Jacksonville, FL 32207 Phone: 904-388-6518 Fax: 904-384-1005 |
Hangyu Shen Watson, M.D. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |
Kayla Marie Demus Wilmot, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1215 Dunn Ave Ste 1, Jacksonville, FL 32218 Phone: 904-745-3618 |
Ryan David Asencios, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |