MR. STEPHEN MATTHEW BROADDUS (PA) – Physician Assistant, NPI 1033452107
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for MR. STEPHEN MATTHEW BROADDUS (PA)
1212 SHENANDOAH AVE
APT A
SAINT LOUIS, MO 631044121
Phone: (618) 267-0401
Type: Mailing
6800 STATE ROUTE 162
MARYVILLE, IL 620628500
Phone: (618) 267-0401
Type: Location
4921 PARKVIEW PL
DEPT ORTHOPAEDIC SURGERY, STE 6A/6B/12A
SAINT LOUIS, MO 631101032
Phone: (314) 514-3500
Fax: (314) 878-7678
Type: Location
PO BOX 7412011
CHICAGO, IL 606742011
Phone: (314) 514-3500
Fax: (314) 878-7678
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $114.
Total Amount is formed as General ($114) + Research ($0) + Ownership ($0) = $114.
Last reported payment date: 2024-12-13 • Largest payer in this snapshot: Lilly USA, LLC ($96).
Total Amount
$114
General + Research + Ownership
Payments
5
Total payment records
General Amount
$114
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $96 |
| Ipsen Biopharmaceuticals, Inc | $17 |
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: 2014-05-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20131218000836 | I | Physician Assistant | MO | TBD |
| I20140520001079 | I | Physician Assistant | IL | 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 |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 1,045 | 193 | $0 |
| 99316 | Nursing facility discharge management, more than 30 minutes | 73 | 68 | $0 |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 59 | 40 | $0 |
| 99497 | Advance care planning, first 30 minutes | 31 | 26 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 28 | 20 | $0 |
Insurance plans in this area (ZIP 63104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| - | MO | |
| - | FL | |
| - | MO | |
| Diagnostic Radiology | IL | |
| - | IL | |
| - | MO | |
| - | MO | |
| - | MO | |
| - | MO |
Reviews
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