DR. JOHN DENNIS BRODERICK (M.D.) – Emergency Medicine Physician, NPI 1588666424

DR. JOHN DENNIS BRODERICK (M.D.) is a healthcare provider. based in Gansevoort, New York. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. 210877-2 (NY). The NPI Number for DR. JOHN DENNIS BRODERICK (M.D.) is 1588666424

Main info

Male
31 Years Of Experience
Name
DR. JOHN DENNIS BRODERICK (M.D.)
NPI
1588666424
Phone
(518) 306-5908
Address
15 FENIMORE PL
Enumeration Date
11 August 2005
Last Update Date
31 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1995 (31 years ago)
PAC ID
8729038070
Professional Enrollment ID
I20260210003887
Address ID
CA927078786SA5XXXXDRXX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Digital endpointsOther names

5,790 EMERGENCY MEDICINE in CA

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Provider Addresses for DR. JOHN DENNIS BRODERICK (M.D.)

  • 15, Fenimore Place, Town of Wilton, Saratoga County, New York, 12831, United States

    GANSEVOORT, NY 128311476

    Phone: (518) 306-5908

    Type: Mailing

  • Center Avenue, Boulevard Gardens, Huntington Beach, Orange County, California, 92655, United States

    HUNTINGTON BEACH, CA 926479152

    Phone: (657) 400-5180

    Type: Location

  • 113 Glenn Pl Unit 100

    Lexington, KY 405053518

    Phone: (833) 358-2278

    Type: Location

  • 2401 Park Dr Ste 101

    Harrisburg, PA 171109303

    Phone: (717) 686-9842

    Type: Location

  • Adirondack Medical Center, 2233 State Rt. 86

    Saranac Lake, NY 12983

    Phone: (518) 897-2570

    Type: Location

  • 1055 Westlakes Dr Ste 3152

    Berwyn, PA 193122410

    Phone: (215) 346-6050

    Fax: (215) 220-3562

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $85.

Total Amount is formed as General ($85) + Research ($0) + Ownership ($0) = $85.

Last reported payment date: 2024-10-02 • Largest payer in this snapshot: ABBVIE INC. ($85).

Total Amount

$85

General + Research + Ownership

Payments

1

Total payment records

General Amount

$85

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-02

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$85
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: 2026-02-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 5 Medicare enrollment records; no due dates published yet.

Enrollment records

5

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
I20050125000802IEmergency MedicineNYTBD
I20190116002224IEmergency MedicinePATBD
I20190516003157IEmergency MedicineCATBD
I20230210000659IEmergency MedicineVATBD
I20260210003887IEmergency MedicineINTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 12831)

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Reviews

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Frequently asked questions

Does DR. JOHN DENNIS BRODERICK (M.D.) have a public NPI I can cite?
Public records show DR. JOHN DENNIS BRODERICK (M.D.) under NPI 1588666424.
Is DR. JOHN DENNIS BRODERICK (M.D.)'s NPI status active today?
Active status means DR. JOHN DENNIS BRODERICK (M.D.)'s NPI record is not deactivated in the public file.
How should patients interpret DR. JOHN DENNIS BRODERICK (M.D.)'s specialty?
The extract shows Emergency Medicine Physician for DR. JOHN DENNIS BRODERICK (M.D.). Clinical services aligned with this taxonomy classification.
Can patients visit DR. JOHN DENNIS BRODERICK (M.D.) in Gansevoort, New York?
For routing, start with Gansevoort, New York for DR. JOHN DENNIS BRODERICK (M.D.), then verify phone and hours locally.
Can I export DR. JOHN DENNIS BRODERICK (M.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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