DR. TARA L BROADWATER (MD) – Psychiatry Physician, NPI 1255310298
Psychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
746 PSYCHIATRY in MN
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Provider Addresses for DR. TARA L BROADWATER (MD)
3647, Windtree Court, Eagan, Dakota County, Minnesota, 55123, United States
EAGAN, MN 551231314
Phone: (507) 304-1899
Type: Location
898 WESCOTT TRL APT 311
EAGAN, MN 551232272
Phone: (507) 304-1899
Type: Mailing
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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-06-21
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 |
|---|---|---|---|---|
| I20040621000537 | I | Psychiatry | MN | 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 |
|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 16 | 11 | $0 |
Insurance plans in this area (ZIP 55123)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| A N E S T H E S I O L O G Y | MN | |
| Nurse Practitioner | SD | |
| - | MN | |
| Diagnostic Radiology | MN | |
| N E U R O L O G Y | MN | |
| - | ND | |
| - | MN | |
| O P T O M E T R Y | SD | |
| Nurse Practitioner | ND |
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