Dr Jerald R Broderick, DC in Elkhart, IN - Medicare Chiropractor Provider

Dr Jerald R Broderick, DC is a medicare enrolled "Chiropractor" provider in Elkhart, Indiana. His current practice location is 1424 Johnson St, Elkhart, Indiana. You can reach out to his office (for appointments etc.) via phone at (574) 264-4151.

Dr Jerald R Broderick is licensed to practice in Indiana (license number 306) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1518923945.

Contact Information

	Dr Jerald R Broderick, DC
	1424 Johnson St, Elkhart, IN 46514-3404
	(574) 264-4151
	(574) 262-9891

Healthcare Provider's Profile

Full Name	Dr Jerald R Broderick
Gender	Male
Speciality	Chiropractor
Location	1424 Johnson St, Elkhart, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1518923945
Provider Enumeration Date: 04/25/2006
Last Update Date: 03/16/2010

Medicare PECOS Information:

PECOS PAC ID: 4385771773
Enrollment ID: I20100415000789

Medical Identifiers

Medical identifiers for Dr Jerald R Broderick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1518923945	NPI	-	NPPES
100112520A	Medicaid	IN
306	Other	IN	COMMERCIAL/WC/AA
000000084724	Other	IN	BLUE CROSS/BLUE SHIELD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
111N00000X	Chiropractor	306 (Indiana)	Primary

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. Dr Jerald R Broderick 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
Dr Jerald R Broderick, DC 1424 Johnson St, Elkhart, IN 46514-3404 Ph: (574) 264-4151	Dr Jerald R Broderick, DC 1424 Johnson St, Elkhart, IN 46514-3404 Ph: (574) 264-4151

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Dr Jerald R Broderick, DC - Medicare Chiropractor in Elkhart, IN