Kevin Stanley Broaddrick, DPM in Peoria, AZ - Medicare Podiatry Provider

Kevin Stanley Broaddrick, DPM is a medicare enrolled "Podiatrist" provider in Peoria, Arizona. He went to William M. Scholl College Of Podiatric Medicine and graduated in 1990 and has 35 years of diverse experience with area of expertise as Podiatry. He is a member of the group practice Active Vital Care Llc and his current practice location is 6739 W Cactus Rd, Peoria, Arizona. You can reach out to his office (for appointments etc.) via phone at (833) 242-0100.

Kevin Stanley Broaddrick is licensed to practice in Arizona (license number POD-000814) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1639188394.

Contact Information

	Kevin Stanley Broaddrick, DPM
	6739 W Cactus Rd, Peoria, AZ 85381-5311
	(833) 242-0100
	(602) 805-4745

Map and Direction

Healthcare Provider's Profile

Full Name	Kevin Stanley Broaddrick
Gender	Male
Speciality	Podiatry
Experience	35 Years
Location	6739 W Cactus Rd, Peoria, Arizona
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kevin Stanley Broaddrick attended and graduated from William M. Scholl College Of Podiatric Medicine in 1990

NPI Data:

NPI Number: 1639188394
Provider Enumeration Date: 08/05/2006
Last Update Date: 08/11/2023

Medicare PECOS Information:

PECOS PAC ID: 1951393867
Enrollment ID: I20150723007902

Medical Identifiers

Medical identifiers for Kevin Stanley Broaddrick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639188394	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
213E00000X	Podiatrist	POD-000814 (Arizona)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Active Vital Care Llc	3870942428	23

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kevin Stanley Broaddrick allows following entities to bill medicare on his behalf.

Provider Name	Angels Valley Community Healthcare Center Pllc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1689303117 PECOS PAC ID: 8628452927 Enrollment ID: O20220906002813

Provider Name	Active Vital Care Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1326825092 PECOS PAC ID: 3870942428 Enrollment ID: O20231208000557

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kevin Stanley Broaddrick is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kevin Stanley Broaddrick, DPM 3149 E Hazeltine Way, Chandler, AZ 85249-9066 Ph: (414) 702-0954	Kevin Stanley Broaddrick, DPM 6739 W Cactus Rd, Peoria, AZ 85381-5311 Ph: (833) 242-0100

Reviews and Comments

Podiatrist in Peoria, AZ

Kaveh Panahi, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 13760 N 93rd Ave Ste 111, Peoria, AZ 85381 Phone: 623-439-2200 Fax: 623-439-7370
Tanya L Thoms, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 9045 W Athens St, Peoria, AZ 85382 Phone: 623-760-5802 Fax: 623-572-3449
Keith Thomas Bangart, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 13660 N 94th Dr, #f1, Peoria, AZ 85381 Phone: 623-974-0522 Fax: 623-933-5787
Kathleen M Stone, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 8325 W Happy Valley Rd, Unit 105, Peoria, AZ 85383 Phone: 602-547-2111 Fax: 602-547-0473
Ryan Daniel Bangart, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 13660 N 94th Dr Ste D1, Peoria, AZ 85381 Phone: 623-974-0522 Fax: 623-933-5787
David M. Bates, Dpm, Pllc Podiatrist Medicare: Medicare Enrolled Practice Location: 15182 N 75th Ave, Suite 180, Peoria, AZ 85381 Phone: 623-243-5737 Fax: 623-399-4091
Margaret A. Withrow, Dpm, Pc Podiatrist Medicare: Medicare Enrolled Practice Location: 13660 N 94th Dr, Ste A-3, Peoria, AZ 85381 Phone: 623-933-4645

Kevin Stanley Broaddrick, DPM - Medicare Podiatrist in Peoria, AZ