MR. WILLIAM GEORGE BROADHURST (PAC) – Physician Assistant, NPI 1740277797

MR. WILLIAM GEORGE BROADHURST (PAC) is a healthcare provider. based in Brookfield, Connecticut. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. 001092 (CT). The NPI Number for MR. WILLIAM GEORGE BROADHURST (PAC) is 1740277797

Main info

Male
25 Years Of Experience
Accepts Medicare Assignment
Name
MR. WILLIAM GEORGE BROADHURST (PAC)
NPI
1740277797
Phone
(203) 775-6205
Address
60 OLD NEW MILFORD RD
Enumeration Date
4 October 2005
Last Update Date
28 October 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2037625588
Graduation Year
2001 (25 years ago)
PAC ID
0042275141
Group Practice PAC ID
4789597691
Professional Enrollment ID
I20041201000083
Address ID
CT068503815NO34XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,244 PHYSICIAN ASSISTANT in CT

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Provider Addresses for MR. WILLIAM GEORGE BROADHURST (PAC)

  • 60, Old New Milford Road, Brookfield Center, Brookfield, Western Connecticut Planning Region, Connecticut, 06804, United States

    SUITE 3E

    BROOKFIELD, CT 068042430

    Phone: (203) 775-6205

    Fax: (203) 775-2414

    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.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-12-01

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20041201000083IPhysician AssistantCTTBD

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.

Verify on CMS Revalidation Lookup Tool

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 06804)

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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: 4789597691View full group profile

Reviews

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Frequently asked questions

What is the registry number for MR. WILLIAM GEORGE BROADHURST (PAC)?
The registry entry for MR. WILLIAM GEORGE BROADHURST (PAC) shows NPI 1740277797.
Does the public listing show MR. WILLIAM GEORGE BROADHURST (PAC) as active?
MR. WILLIAM GEORGE BROADHURST (PAC)'s NPI record reflects an active status in NPPES.
How should patients interpret MR. WILLIAM GEORGE BROADHURST (PAC)'s specialty?
The extract shows Physician Assistant for MR. WILLIAM GEORGE BROADHURST (PAC). Clinical services aligned with this taxonomy classification.
Can patients visit MR. WILLIAM GEORGE BROADHURST (PAC) in Brookfield, Connecticut?
For routing, start with Brookfield, Connecticut for MR. WILLIAM GEORGE BROADHURST (PAC), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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