MELISSA BROADDUS (O.D.) – Optometrist, NPI 1376977439

MELISSA BROADDUS (O.D.) is a healthcare provider. based in Memphis, Tennessee. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 3117 (TN). The NPI Number for MELISSA BROADDUS (O.D.) is 1376977439

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
MELISSA BROADDUS (O.D.)
NPI
1376977439
Phone
(901) 357-0371
Address
2070 WHITNEY AVE
Enumeration Date
26 August 2013
Last Update Date
26 August 2013

Doctor Profile

Medical School Name
SOUTHERN COLLEGE OF OPTOMETRY
Secondary Phone
4178877151
Graduation Year
2013 (13 years ago)
PAC ID
8224263256
Group Practice PAC ID
5193970648
Professional Enrollment ID
I20150714001572
Address ID
MO658076069SP3626XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

957 OPTOMETRY in TN

Provider Addresses for MELISSA BROADDUS (O.D.)

  • 2070 WHITNEY AVE

    MEMPHIS, TN 381279014

    Phone: (901) 357-0371

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 22 Open Payments records for all available years, with a total value of $945.

Total Amount is formed as General ($945) + Research ($0) + Ownership ($0) = $945.

Last reported payment date: 2024-11-08 • Largest payer in this snapshot: CooperVision Inc. ($370).

Total Amount

$945

General + Research + Ownership

Payments

22

Total payment records

General Amount

$945

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-08

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: 2015-07-14

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
I20150714001572IOptometryMOTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes2919$0
66984Removal of cataract with insertion of prosthetic lens2111$0
92250Photography of the retina1211$0
View full utilization report →

Insurance plans in this area (ZIP 38127)

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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: 5193970648View full group profile
NameSpecialtyState
O P T O M E T R YMO
O P T O M E T R YMO
O P T O M E T R YMI

Reviews

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Frequently asked questions

Is MELISSA BROADDUS (O.D.) listed with a National Provider Identifier?
Yes — MELISSA BROADDUS (O.D.) has NPI 1376977439 on file in the registry.
Is MELISSA BROADDUS (O.D.) still an active registrant?
MELISSA BROADDUS (O.D.) carries an active NPI according to the public dataset.
How would a patient describe MELISSA BROADDUS (O.D.)'s focus?
For MELISSA BROADDUS (O.D.), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
What locale is associated with MELISSA BROADDUS (O.D.)?
Directory geography for MELISSA BROADDUS (O.D.) centers on Memphis, Tennessee.
Can I trust this NPI listing for MELISSA BROADDUS (O.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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