THOMAS BRODERICK (NPI# 1396722252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396722252 |
| Entity Type | Individual |
| Full Name | THOMAS BRODERICK |
| Credential | M.D. |
| Practice Address |
2123 Auburn Ave Suite 136 Cincinnati OH 45219-2906 |
| Mailing Address |
237 William Howard Taft Rd 2nd Floor, Cbo2-3 Cincinnati OH 45219-2610 |
| Practice Telephone | 5132061060 |
| Practice Fax Number | 5132061062 |
| Mailing Telephone | 5132061060 |
| Mailing Fax Number | 5132061062 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2020-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
35057828 | OH | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
35.057828 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100387030 | 05 | |
| HUMANA | 57828-05 | 01 | |
| OH | ANTHEM | 000000215162 | 01 |
| OH | AETNA | 0643141 | 01 |
| KY | 64862899 | 05 | |
| OH | 64862899 | 05 | |
| OH | CARESOURCE MEDICAID OH | 311438871037 | 01 |
| UNITED | 25-20393 | 01 | |
| OH | AMERIGROUP MEDICAID OH | 284911 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679901581 | Thomas Broderick | Dentist | 500 Eisenhower Dr, Savannah, GA 31406-2608 | 2013-10-31 |
| 1912156340 | Thomas Patrick Broderick II | Registered Nurse | 15655 State Route 170 Ste A, East Liverpool, OH 43920-9672 | 2008-09-10 |
| 1407878853 | Thomas W Broderick | Radiology | 190 E Bannock St, Boise, ID 83712-6241 | 2006-07-24 |
| 1083646681 | Thomas F Broderick | Emergency Medicine | 195 Industrial Pkwy, Nvrh Corner Medical, Lyndon, VT 05849 | 2006-07-06 |
| 1912973496 | Thomas P Broderick | Anesthesiology | 600 Highland Ave, Madison, WI 53792 | 2006-02-24 |
| Street Address |
2123 AUBURN AVE SUITE 136 |
| City | CINCINNATI |
| State | OH |
| Zip Code | 45219-2906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750380341 | Eli M Roth | Internal Medicine | 2123 Auburn Ave, Suite 624, Cincinnati, OH 45219-2906 | 2005-07-18 |
| 1285120253 | Tiffany Kocher | Nurse Practitioner | 2123 Auburn Ave, Cincinnati, OH 45219 | 2018-07-02 |
| 1164944120 | Hannah Eppensteiner | Registered Nurse | 2123 Auburn Ave, Cincinnati, OH 45219-2906 | 2017-07-12 |
| 1043744063 | Miranda Jean Miller | Nurse Practitioner | 2123 Auburn Ave, Suite 401, Cincinnati, OH 45219 | 2017-04-17 |
| 1437681764 | Eric Edward Cooney | Family Medicine | 2123 Auburn Ave, Suite 340, Cincinnati, OH 45219-2906 | 2017-03-27 |
| 1811428097 | Shelby Nicole Dvorak | Family Medicine | 2123 Auburn Ave, Suite 235, Cincinnati, OH 45219 | 2017-03-21 |
| 1043751225 | Christian Erik Gausvik Jr. | Family Medicine | 2123 Auburn Ave, Suite 340, Cincinnati, OH 45219 | 2017-03-20 |
| 1578003620 | Rachel Steele | Registered Nurse | 2123 Auburn Ave, Cincinnati, OH 45219-2906 | 2017-03-07 |
| 1013456029 | Jill Gast | Nurse Practitioner | 2123 Auburn Ave, Suite 320, Cincinnati, OH 45219-2906 | 2017-02-23 |
| 1235680117 | Brigid Coleen Malone | Nurse Practitioner | 2123 Auburn Ave, Suite 139, Cincinnati, OH 45219-2906 | 2016-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225659261 | Christopher Robert Smith | Student in an Organized Health Care Education/Training Program | 2139 Auburn Ave Tch Internal Medicine, Cincinnati, OH 45219 | 2020-04-30 |
| 1316574346 | Quincy Alvin Banks | Student in an Organized Health Care Education/Training Program | Tch Family Medicine, 2123 Auburn Ave, Suite 235, Cincinnati, OH 45219 | 2020-03-27 |
| 1831725324 | Sara Jane Elisabeth Hubbard | Student in an Organized Health Care Education/Training Program | 234 Goodman Street Ml 0803, Ucmc Dental Center, Cincinnati, OH 45219 | 2020-03-17 |
| 1528609815 | Yuliya Azirbayeva | Pharmacist | 3 West Corry St, Cincinnati, OH 45219 | 2019-10-08 |
| 1851955769 | Julie Grace Van Baardwijk | Student in an Organized Health Care Education/Training Program | Tch Internal Medicine, 2139 Auburn Ave, Cincinnati, OH 45219 | 2019-04-25 |
| 1164982773 | Zein Mouaffaq Saad Eddin | Student in an Organized Health Care Education/Training Program | 234 Goodman Street, Department of Surgery, Cincinnati, OH 45219 | 2019-03-20 |
| 1386103273 | Ismaeel Siddiqi | Student in an Organized Health Care Education/Training Program | 234 Goodman Street Ml 0781- Internal Medicine, Cincinatti, OH 45219 | 2019-03-19 |
| 1285123612 | Anna Vaughan | Counselor | 2828 Vernon Place, Cincinnati, OH 45219 | 2018-05-01 |
| 1043707565 | Chizara Nwade | Student in an Organized Health Care Education/Training Program | Tch Internal Medicine, 2139 Auburn Ave, Cincinnati, OH 45219 | 2018-04-19 |
| 1922503226 | Kristen Sparagna | Student in an Organized Health Care Education/Training Program | 234 Goodman St, Ml 665x, Cincinnati, OH 45219 | 2018-03-28 |
| Find all providers in zip 45219 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316445695 | Cardiac Cin of Cincinnati LLC | Internal Medicine | 9435 Waterstone Blvd Ste 140-302, Cincinnati, OH 45249-8226 | 2018-01-31 |
| 1851396428 | Puvi N Seshiah | Internal Medicine | 3219 Clifton Ave, Suite 400, Cincinnati, OH 45220-3027 | 2005-06-20 |
| 1811150816 | Saad Saifuddin Ahmad | Internal Medicine | 234 Goodman St, Cincinnati, OH 45219-2364 | 2008-07-09 |
| 1285891481 | Donald Ray Lynch Jr. | Internal Medicine | 234 Goodman Street, Cincinnati, OH 45219 | 2008-05-16 |
| 1730278391 | Sarosh P Batlivala | Internal Medicine | 3333 Burnet Ave., Ml 2003, Cincinnati, OH 45229-3026 | 2006-10-12 |
| 1285624544 | Seid Ali Razavi | Internal Medicine | 3219 Clifton Ave, Suite 400, Cincinnati, OH 45220-3027 | 2005-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730799347 | Warren Endovascular Associates LLC | Internal Medicine | 1950 Niles Cortland Rd Ne Ste 12, Warren, OH 44484-1077 | 2020-08-07 |
| 1821570128 | Rishi Puri | Internal Medicine | 9500 Euclid Ave # J2-208, Cleveland, OH 44195-0001 | 2018-09-04 |
| 1760980049 | Cardiac Cin of Columbus LLC | Internal Medicine | 175 S 3rd St Ste 200-248, Columbus, OH 43215-5134 | 2018-01-31 |
| 1720462591 | Midwest Access Services LLC | Internal Medicine | 7335 Yankee Rd Ste 101, Liberty Township, OH 45044-0008 | 2015-07-12 |
| 1306878863 | Medcentral Professional Association Inc. | Internal Medicine | 308 Glessner Ave, Mansfield, OH 44903-2225 | 2006-07-07 |
| 1629077961 | Gregory J Wood | Internal Medicine | 7200 Mentor Ave, Mentor, OH 44060-7522 | 2005-07-19 |
| 1508865213 | Joseph Michael Surmitis | Internal Medicine | 4082 Fulton Dr Nw, Canton, OH 44718-2866 | 2005-07-15 |
| 1669474839 | David G Bichsel | Internal Medicine | 745 W State St, Ste 750, Columbus, OH 43222-1515 | 2005-06-01 |
| 1427656420 | Sarah Nicole Blair | Internal Medicine | 13207 Ravenna Rd, Chardon, OH 44024-7032 | 2020-10-12 |
| 1174185607 | Vinayak Nagaraja | Internal Medicine | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2019-07-04 |
| Find all providers with the same taxonomy | ||||
| City | CINCINNATI |
| Zip Code | 45219 |
Please comment or provide details below to improve the information on THOMAS BRODERICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.