MELISSA BROADUS (FNP-C) – Family Nurse Practitioner, NPI 1255176095

MELISSA BROADUS (FNP-C) is a healthcare provider. based in Lubbock, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 1167688 (TX). The NPI Number for MELISSA BROADUS (FNP-C) is 1255176095

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
MELISSA BROADUS (FNP-C)
NPI
1255176095
Phone
(806) 775-8200
Address
808 JOLIET AVE
Enumeration Date
25 June 2024
Last Update Date
25 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8067758459
Graduation Year
2024 (2 years ago)
PAC ID
7113463985
Group Practice PAC ID
4284617507
Professional Enrollment ID
I20240729002894
Address ID
TX794242274LU11011RDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for MELISSA BROADUS (FNP-C)

  • 808 JOLIET AVE

    LUBBOCK, TX 794151149

    Phone: (806) 775-8200

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-07-29

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
I20240729002894INurse PractitionerTXTBD

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 79415)

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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: 4284617507View full group profile
NameSpecialtyState
Family PracticeTX
Pediatric MedicineTX
Physician AssistantTX
Nurse PractitionerTX
Emergency MedicineTX
Nurse PractitionerTX
Nurse PractitionerTX
Emergency MedicineTX
Nurse PractitionerTX
Emergency MedicineTX

Reviews

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Frequently asked questions

Can I cross-check MELISSA BROADUS (FNP-C) using NPI 1255176095?
NPI 1255176095 belongs to MELISSA BROADUS (FNP-C); compare other details if you need extra assurance.
Would MELISSA BROADUS (FNP-C) appear as active to a payer?
You can treat MELISSA BROADUS (FNP-C) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to MELISSA BROADUS (FNP-C)?
MELISSA BROADUS (FNP-C)'s specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Texas is MELISSA BROADUS (FNP-C) registered?
Use Lubbock, Texas as the headline location for MELISSA BROADUS (FNP-C) here.
When was this NPI issued?
Enumeration for MELISSA BROADUS (FNP-C) is noted as June 25, 2024 where the registry provides it.

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