J. BROADWATER (MD) – Surgical Oncology Physician, NPI 1043300619

Surgical Oncology Physician

J. BROADWATER (MD) is a healthcare provider. based in Little rock, Arkansas. specializing in Surgical Oncology Physician. They hold the professional credentials MD. They hold a License No. C-6025 (AR). The NPI Number for J. BROADWATER (MD) is 1043300619

Main info

Male

45 Years Of Experience

Accepts Medicare Assignment

Name

J. BROADWATER (MD)

NPI

1043300619

Phone

(501) 686-8000

Address

4301 W MARKHAM ST # 783

Enumeration Date

13 October 2006

Last Update Date

7 January 2008

Doctor Profile

Medical School Name

UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE

Secondary Phone

Graduation Year

1981 (45 years ago)

PAC ID

6002958642

Group Practice PAC ID

4082528955

Professional Enrollment ID

I20100120000884

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience52

Completeness75

Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for J. BROADWATER (MD)

783, West Markham Street, Little Rock, Pulaski County, Arkansas, 72201, United States
LITTLE ROCK, AR 722057101
Phone: (501) 686-8000
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72205)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 4082528955View full group profile

Name	Specialty	State
SUKANTHI KOVVURU	N E U R O L O G Y	AR
Unknown Individual	-	AR
ASIS SHRESTHA (MD)	Internal Medicine	NY
JOHN M ARTHUR (MD)	Internal Medicine, Nephrology	AR
DR. UMA MAHESH MATAPATHI (M.D)	Diagnostic Radiology	AR
MANISH GOPE RAISINGANI	-	AR
CARL PRESTON MCCORMACK (MD)	-	AR
REBECCA A CAMP	Nurse Practitioner	AR
DR. JON RUBENOW (MD)	P S Y C H I A T R Y	AR
KATHRYN NEWTON ROWLEY (APN)	-	AR

Reviews

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Frequently asked questions

Is J. BROADWATER (MD) listed with a National Provider Identifier?

Yes — J. BROADWATER (MD) has NPI 1043300619 on file in the registry.

Active or inactive — what applies to J. BROADWATER (MD)?

You should see J. BROADWATER (MD) as active in CMS-hosted NPPES data.

How would a patient describe J. BROADWATER (MD)'s focus?

For J. BROADWATER (MD), the primary taxonomy reads as Surgical Oncology Physician. Clinical services aligned with this taxonomy classification.

What practice footprint exists for J. BROADWATER (MD)?

Travel planning: use Little Rock, Arkansas as the reference point for J. BROADWATER (MD), then confirm.

What does 2 location(s) imply?

2 practice locations appear in the available data.

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