Dr Wallace Broadbent, DO in Kalamazoo, MI - Medicare Emergency Medicine

Dr Wallace Broadbent, DO is a medicare enrolled "Emergency Medicine" physician in Kalamazoo, Michigan. His current practice location is 1535 Gull Rd, Msb 015, Kalamazoo, Michigan. You can reach out to his office (for appointments etc.) via phone at (269) 226-6933.

Dr Wallace Broadbent is licensed to practice in Michigan (license number 5101011784) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1861443202.

Contact Information

	Dr Wallace Broadbent, DO
	1535 Gull Rd, Msb 015, Kalamazoo, MI 49048-1650
	(269) 226-6933
	(269) 226-6949

Map and Direction

Physician's Profile

Full Name	Dr Wallace Broadbent
Gender	Male
Speciality	Emergency Medicine
Location	1535 Gull Rd, Kalamazoo, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1861443202
Provider Enumeration Date: 05/12/2006
Last Update Date: 02/10/2009

Medicare PECOS Information:

PECOS PAC ID: 8426045212
Enrollment ID: I20040426000827

Medical Identifiers

Medical identifiers for Dr Wallace Broadbent such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861443202	NPI	-	NPPES
3123256-11	Other	MI	MEDICAID - THREE RIVERS
700G560080	Other	MI	BCBS GROUP-THREE RIVERS HEALTH
WB011784	Other	MI	BLUE CROSS BLUE SHIELD
114572856	Medicaid	MI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	5101011784 (Michigan)	Primary
208D00000X	General Practice	5101011784 (Michigan)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Wallace Broadbent allows following entities to bill medicare on his behalf.

Entity Name	Ascension Borgess Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568416311 PECOS PAC ID: 5294645750 Enrollment ID: O20040209000029

Entity Name	Kalamazoo Emergency Associates, Plc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942251244 PECOS PAC ID: 5890685473 Enrollment ID: O20040317001078

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Wallace Broadbent is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Wallace Broadbent, DO 1535 Gull Rd, Msb 015, Kalamazoo, MI 49048-1650 Ph: (269) 226-6933	Dr Wallace Broadbent, DO 1535 Gull Rd, Msb 015, Kalamazoo, MI 49048-1650 Ph: (269) 226-6933

Reviews and Comments

Emergency Medicine Doctors in Kalamazoo, MI

Nicole Catherine Carpp, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 125 S Kalamazoo Mall Ste 204, Kalamazoo, MI 49007 Phone: 269-343-3900
Dr. Brannon Charles Duncan, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1850 Whites Rd, Suite 3, Kalamazoo, MI 49008 Phone: 269-343-3900 Fax: 269-343-5640
Abigail Munro Harrelson, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Oakland Dr, Kalamazoo, MI 49008 Phone: 269-337-6600 Fax: 269-337-6475
Dr. Charles Moore, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1535 Gull Rd, Msb 015, Kalamazoo, MI 49048 Phone: 269-226-6933 Fax: 269-226-6949
Dr. Jonathan Ross Dadurian, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 125 S Kalamazoo Mall, Ste 204, Kalamazoo, MI 49007 Phone: 269-343-3900
Jason Andrew Garner, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Oakland Dr, Kalamazoo, MI 49008 Phone: 269-337-6600 Fax: 269-337-6475
Nicholas Dyga, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 125 S Kalamazoo Mall Ste 204, Kalamazoo, MI 49007 Phone: 269-343-3900

Dr Wallace Broadbent, DO - Medicare Emergency Medicine in Kalamazoo, MI