KELLY CLARK BRODERICK (M.D.) – Diagnostic Radiology Physician, NPI 1609821891
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,800 DIAGNOSTIC RADIOLOGY in CA
Provider Addresses for KELLY CLARK BRODERICK (M.D.)
222 W 39th Ave
San Mateo, CA 944034364
Phone: (650) 573-2222
Fax: (650) 573-2122
Type: Location
1501 Trousdale Dr
Burlingame, CA 940104506
Phone: (650) 696-5515
Fax: (650) 696-5280
Type: Location
Novato Post Office, South Novato Boulevard, Novato, Marin County, California, 94945, United States
NOVATO, CA 949486102
Phone: (415) 884-3418
Fax: (415) 883-3406
Type: Mailing
Mills Health Center, 100, South San Mateo Drive, San Mateo, San Mateo County, California, 94401, United States
SAN MATEO, CA 944013805
Phone: (650) 696-4515
Fax: (650) 696-4626
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $27.
Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.
Last reported payment date: 2023-05-09 • Largest payer in this snapshot: Siemens Medical Solutions USA, Inc. ($27).
Total Amount
$27
General + Research + Ownership
Payments
1
Total payment records
General Amount
$27
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Siemens Medical Solutions USA, Inc. | $27 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-07-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080714000398 | I | Diagnostic Radiology | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 77067 | Screening mammography | 664 | 664 | $0 |
| 77063 | Screening 3d breast mammography | 654 | 654 | $0 |
| 77080 | Dxa bone density measurement of hip, pelvis, spine | 357 | 357 | $0 |
| 71045 | X-ray of chest, 1 view | 233 | 224 | $0 |
| 76705 | Limited ultrasound scan of abdomen | 194 | 189 | $0 |
Insurance plans in this area (ZIP 94403)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | CA | 73110 | X-ray of wrist, minimum of 3 views | 13 | 11 |
| DIAGNOSTIC RADIOLOGY | CA | 73562 | X-ray of knee, 3 views | 30 | 22 |
| DIAGNOSTIC RADIOLOGY | CA | 73630 | X-ray of foot, minimum of 3 views | 42 | 38 |
| DIAGNOSTIC RADIOLOGY | CA | 74177 | CT scan of abdomen and pelvis with contrast | 136 | 127 |
| DIAGNOSTIC RADIOLOGY | CA | 76830 | Ultrasound pelvis through vagina | 47 | 46 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| - | CA | |
| Family Practice | WA | |
| - | CT | |
| - | CA | |
| - | CA | |
| - | CA | |
| - | IL | |
| - | CA | |
| Nurse Practitioner | CA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.