NICHOLAS BROADBENT (D.O.) – Vascular & Interventional Radiology Physician, NPI 1356721872

NICHOLAS BROADBENT (D.O.) is a healthcare provider. based in Peoria, Illinois. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials D.O.. They hold a License No. 05808 (IA). The NPI Number for NICHOLAS BROADBENT (D.O.) is 1356721872

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
NICHOLAS BROADBENT (D.O.)
NPI
1356721872
Phone
(309) 655-7768
Address
530 NE GLEN OAK AVE
Enumeration Date
1 June 2015
Last Update Date
18 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6414240102
Graduation Year
2015 (11 years ago)
PAC ID
8426363946
Group Practice PAC ID
4981592730
Professional Enrollment ID
I20210625002426
Address ID
IA504014818MA1416XSWXX400

Contacts

Secure Messaging
mc.mmcmc.him@direct.2.mycarefile.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness85
Years active:11State licenses:1Other namesUpdated within 12 months

2,123 DIAGNOSTIC RADIOLOGY in IL

Provider Addresses for NICHOLAS BROADBENT (D.O.)

  • 530 NE GLEN OAK AVE

    PEORIA, IL 616370001

    Phone: (309) 655-7768

    Type: Location

  • 403 1st St SE

    Belmond, IA 504211201

    Phone: (844) 474-4321

    Fax: (641) 444-5554

    Type: Location

  • 1924 Superior St

    Webster City, IA 505953146

    Phone: (844) 474-4321

    Fax: (515) 832-1114

    Type: Location

  • 1316 S Main St

    Clarion, IA 505252019

    Phone: (844) 474-4321

    Fax: (515) 532-3119

    Type: Location

  • 104 S Story St

    Boone, IA 500364737

    Phone: (844) 474-4321

    Fax: (515) 432-2895

    Type: Location

  • 2700 1st Ave S Ste 100

    Fort Dodge, IA 505014300

    Phone: (844) 474-4321

    Fax: (515) 576-8581

    Type: Location

  • 401 S 17th St

    Clear Lake, IA 504282304

    Phone: (844) 474-4321

    Fax: (515) 832-1400

    Type: Location

  • 840 W US Highway 18

    Garner, IA 504381023

    Phone: (844) 474-4321

    Fax: (641) 925-1507

    Type: Location

  • 1416 6TH ST SW

    MASON CITY, IA 504014818

    Phone: (641) 424-0102

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $45.

Total Amount is formed as General ($45) + Research ($0) + Ownership ($0) = $45.

Last reported payment date: 2024-03-15 • Largest payer in this snapshot: Terumo Medical Corporation ($16).

Total Amount

$45

General + Research + Ownership

Payments

3

Total payment records

General Amount

$45

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-15

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: 2021-06-25

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
I20210625002426IDiagnostic RadiologyIATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
71045X-ray of chest, 1 view125101$0
71046X-ray of chest, 2 views9589$0
93922Ultrasound study of arm and leg arteries8780$0
93880Ultrasound of both sides of head and neck blood flow8585$0
93971Ultrasound study of one arm or leg veins with compression and maneuvers7973$0
View full utilization report →

Insurance plans in this area (ZIP 61637)

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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: 4981592730View full group profile
NameSpecialtyState
Diagnostic RadiologyIA
Diagnostic RadiologyIA
Diagnostic RadiologyIA
-IA
Diagnostic RadiologyIA
Diagnostic RadiologyIA
Diagnostic RadiologyIA
Diagnostic RadiologyIN

Reviews

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Frequently asked questions

Does NICHOLAS BROADBENT (D.O.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — NICHOLAS BROADBENT (D.O.) uses 1356721872.
Can I rely on NICHOLAS BROADBENT (D.O.) being an active provider?
As of the registry snapshot, NICHOLAS BROADBENT (D.O.) is marked active.
What is NICHOLAS BROADBENT (D.O.)'s specialty?
The listing groups NICHOLAS BROADBENT (D.O.) with Vascular & Interventional Radiology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for NICHOLAS BROADBENT (D.O.)?
NICHOLAS BROADBENT (D.O.)'s geographic hint is Peoria, Illinois in our summary view.
Why does NICHOLAS BROADBENT (D.O.) have multiple addresses?
10 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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