MICHLENE BROADNEY (MD) – Obstetrics & Gynecology Physician, NPI 1629062153

MICHLENE BROADNEY (MD) is a healthcare provider. based in Fayetteville, Georgia. specializing in Obstetrics & Gynecology Physician. They hold the professional credentials MD. They hold a License No. 055207 (GA). The NPI Number for MICHLENE BROADNEY (MD) is 1629062153

Main info

Female
26 Years Of Experience
Accepts Medicare Assignment
Name
MICHLENE BROADNEY (MD)
NPI
1629062153
Phone
(770) 991-2200
Address
1279 HIGHWAY 54 W
Enumeration Date
12 September 2005
Last Update Date
22 October 2011

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7709912200
Graduation Year
2000 (26 years ago)
PAC ID
5597705020
Group Practice PAC ID
4688565716
Professional Enrollment ID
I20050504000722
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

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Provider Addresses for MICHLENE BROADNEY (MD)

  • 1279, Highway 54 West, Fayetteville, Fayette County, Georgia, 30214, United States

    SUITE 220

    FAYETTEVILLE, GA 302144552

    Phone: (770) 991-2200

    Fax: (770) 991-1341

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $17.

Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.

Last reported payment date: 2023-03-27 • Largest payer in this snapshot: Hologic Sales and Service, LLC ($17).

Total Amount

$17

General + Research + Ownership

Payments

1

Total payment records

General Amount

$17

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-27

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2005-05-04

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
I20050504000722IObstetrics/GynecologyGATBD

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 30214)

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Provider's Procedures

MICHLENE BROADNEY (MD) performs procedures in Obstetrics & Gynecology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OBSTETRICS/GYNECOLOGYGA81002Urinalysis, manual test4947

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: 4688565716View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YGA
-GA
-VA
O B S T E T R I C S/ G Y N E C O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YGA
-FL
O B S T E T R I C S/ G Y N E C O L O G YTN
O B S T E T R I C S/ G Y N E C O L O G YPA

Reviews

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Frequently asked questions

What unique ID ties claims to MICHLENE BROADNEY (MD)?
NPI 1629062153 is assigned to MICHLENE BROADNEY (MD) under the national enumeration system.
Is MICHLENE BROADNEY (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is MICHLENE BROADNEY (MD)?
The page reflects Obstetrics & Gynecology Physician for MICHLENE BROADNEY (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for MICHLENE BROADNEY (MD)?
The page summarizes Fayetteville, Georgia for MICHLENE BROADNEY (MD); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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