ELLIOT DUANE BROADHEAD (DPT) – Physical Therapist, NPI 1255996468

ELLIOT DUANE BROADHEAD (DPT) is a healthcare provider. based in Mountain home afb, Idaho. specializing in Physical Therapist. They hold the professional credentials DPT. They hold a License No. 5817 (ID). The NPI Number for ELLIOT DUANE BROADHEAD (DPT) is 1255996468

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
ELLIOT DUANE BROADHEAD (DPT)
NPI
1255996468
Phone
(208) 828-4626
Address
90 HOPE DR BLDG 6000
Enumeration Date
2 May 2019
Last Update Date
18 September 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2087362574
Graduation Year
2018 (8 years ago)
PAC ID
3870828098
Group Practice PAC ID
1759612641
Professional Enrollment ID
I20190710003238
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

Provider Addresses for ELLIOT DUANE BROADHEAD (DPT)

  • 90 HOPE DR BLDG 6000

    MOUNTAIN HOME AFB, ID 836481062

    Phone: (208) 828-4626

    Type: Location

  • Falls Avenue East, Twin Falls, Twin Falls County, Idaho, 83301, United States

    TWIN FALLS, ID 833013455

    Phone: (208) 736-2574

    Fax: (208) 736-2594

    Type: Mailing

  • 1945, Hiland Avenue, Burley, Cassia County, Idaho, 83318, United States

    BURLEY, ID 833182714

    Phone: (208) 647-0224

    Fax: (208) 647-0239

    Type: Location

  • 1410 W AIRBASE RD APT 2

    MOUNTAIN HOME, ID 836473344

    Phone: (208) 730-7467

    Type: Mailing

  • 527 5TH AVE #500

    SHEPPARD AFB, TX 76311

    Phone: (208) 828-4626

    Type: Location

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.

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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.

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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 83648)

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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: 1759612641View full group profile
NameSpecialtyState
-ID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID
-ID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID
Physical Therapist In Private PracticeID

Reviews

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Frequently asked questions

How do I look up ELLIOT DUANE BROADHEAD (DPT) by NPI?
Use NPI 1255996468 when you need to reference ELLIOT DUANE BROADHEAD (DPT) in forms, claims, or directories.
Is ELLIOT DUANE BROADHEAD (DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does ELLIOT DUANE BROADHEAD (DPT) list a primary specialty?
If you are matching referrals, note Physical Therapist for ELLIOT DUANE BROADHEAD (DPT). Clinical services aligned with this taxonomy classification.
What location metadata exists for ELLIOT DUANE BROADHEAD (DPT)?
The page summarizes Mountain Home Afb, Idaho for ELLIOT DUANE BROADHEAD (DPT); expand the address list for detail.
How can I contact ELLIOT DUANE BROADHEAD (DPT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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