MR. JEREMY WILLIAM BROUILLETTE (D.P.M.) – Podiatrist, NPI 1477969806
Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
433 PODIATRY in VA
Provider Addresses for MR. JEREMY WILLIAM BROUILLETTE (D.P.M.)
919 CAMELOT DR APT 46
SALEM, VA 241535655
Phone:
Type: Mailing
1970 ROANOKE BLVD
BLDG 143, PODIATRY DEPARTMENT
SALEM, VA 241536404
Phone: (540) 982-2463
Type: Location
1940 E. STATE HWY 114
SUITE 150
SOUTHLAKE, TX 760926526
Phone: (817) 424-3668
Fax: (817) 442-8637
Type: Mailing
ACADEMY FOOT & ANKLE SPECIALISTS
1940 E. STATE HWY 114, SUITE 150
SOUTHLAKE, TX 760926526
Phone: (817) 424-3668
Fax: (817) 442-8637
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 $16.
Total Amount is formed as General ($16) + Research ($0) + Ownership ($0) = $16.
Last reported payment date: 2023-05-12 • Largest payer in this snapshot: Organogenesis Inc. ($16).
Total Amount
$16
General + Research + Ownership
Payments
1
Total payment records
General Amount
$16
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $16 |
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: 2025-08-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20170623001800 | I | Podiatry | WV | TBD |
| I20170911000241 | I | Podiatry | VA | TBD |
| I20250828001826 | I | Podiatry | DC | 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 |
|---|---|---|---|---|
| 11720 | Removal of fingernails or toenails, 1-5 nails | 843 | 426 | $0 |
| 11056 | Removal of noncancer thickened skin growth, 2-4 growths | 159 | 94 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 144 | 117 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 115 | 115 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 90 | 30 | $0 |
Insurance plans in this area (ZIP 24153)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | CA | |
| P O D I A T R Y | MN | |
| P O D I A T R Y | MA | |
| P O D I A T R Y | MA | |
| P O D I A T R Y | MA | |
| P O D I A T R Y | ND | |
| P O D I A T R Y | MN | |
| P O D I A T R Y | FL | |
| - | MA | |
| P O D I A T R Y | NY |
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