JEREMY PHILLIPPE BROADNAX (M.D.) – Pain Medicine (Anesthesiology) Physician, NPI 1326204611
Pain Medicine (Anesthesiology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
158 PAIN MANAGEMENT in MO
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Provider Addresses for JEREMY PHILLIPPE BROADNAX (M.D.)
12700 SOUTHFORK RD STE 155
SAINT LOUIS, MO 631283276
Phone: (314) 525-7780
Fax: (314) 525-7795
Type: Mailing
320, East Seminole Street, Seminole/Holland, Springfield, Greene County, Missouri, 65807, United States
SPRINGFIELD, MO 658042227
Phone: (417) 820-2064
Type: Mailing
1229, East Seminole Street, Meador Park, Springfield, Greene County, Missouri, 65804, United States
STE 320
SPRINGFIELD, MO 65804
Phone: (417) 820-2064
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $88.
Total Amount is formed as General ($88) + Research ($0) + Ownership ($0) = $88.
Last reported payment date: 2024-06-25 • Largest payer in this snapshot: Medtronic, Inc. ($88).
Total Amount
$88
General + Research + Ownership
Payments
2
Total payment records
General Amount
$88
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-25
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $88 |
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: 2013-10-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131025001047 | I | Pain Management | MO | 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 |
|---|---|---|---|---|
| 62323 | Injection of substance into lower spine canal using imaging guidance | 139 | 106 | $0 |
| 27096 | Injection of anesthetic or steroid into joint between lower spine and hip bone using imaging guidance | 138 | 98 | $0 |
| 64494 | Injection of lower or sacral spine facet joint using imaging guidance, second level | 109 | 68 | $0 |
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 109 | 68 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 108 | 80 | $0 |
Insurance plans in this area (ZIP 63128)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY | MO | 20610 | Aspiration and/or injection of large joint or joint capsule | 61 | 51 |
| ANESTHESIOLOGY | MO | 62311 | Injections of substances into lower or sacral spine | 68 | 42 |
| ANESTHESIOLOGY | MO | 64493 | Injections of lower or sacral spine facet joint using imaging guidance | 38 | 26 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| - | MO | |
| - | MO | |
| - | MO | |
| Clinical Psychologist | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| U R O L O G Y | MO | |
| P O D I A T R Y | MO | |
| - | KS |
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