Dr Nicole Stack Broerman, MD in Hinesville, GA

Dr Nicole Stack Broerman, MD is a medicare enrolled "Pediatrics" physician in Hinesville, Georgia. Her current practice location is 462 Elma G Miles Pkwy, Hinesville, Georgia. You can reach out to her office (for appointments etc.) via phone at (912) 369-9400.

Dr Nicole Stack Broerman is licensed to practice in Georgia (license number 47265) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1013902741.

Contact Information

	Dr Nicole Stack Broerman, MD
	462 Elma G Miles Pkwy, Hinesville, GA 31313-4000
	(912) 369-9400
	(912) 877-9438

Map and Direction

Physician's Profile

Full Name	Dr Nicole Stack Broerman
Gender	Female
Speciality	Pediatrics
Location	462 Elma G Miles Pkwy, Hinesville, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013902741
Provider Enumeration Date: 09/19/2005
Last Update Date: 04/17/2018

Medicare PECOS Information:

PECOS PAC ID: 4284986878
Enrollment ID: I20181009003224

Medical Identifiers

Medical identifiers for Dr Nicole Stack Broerman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013902741	NPI	-	NPPES
T74835	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	47265 (Georgia)	Primary

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 Nicole Stack Broerman allows following entities to bill medicare on her behalf.

Entity Name	Hospital Authority Of Liberty County
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326079260 PECOS PAC ID: 5799772190 Enrollment ID: O20040428000377

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 Nicole Stack Broerman 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 Nicole Stack Broerman, MD Po Box 919, Hinesville, GA 31310-0919 Ph: (912) 369-9400	Dr Nicole Stack Broerman, MD 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 Ph: (912) 369-9400

Reviews and Comments

Pediatrics Doctors in Hinesville, GA

Kijana Nicola Nix, MD,FAAP Pediatrics Medicare: Medicare Enrolled Practice Location: 455 S Main St Ste 103, Hinesville, GA 31313 Phone: 912-408-6868 Fax: 912-876-6566
Dr. Phillip O Ajayi, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 455 S Main St Ste 101, Hinesville, GA 31313 Phone: 912-876-6868 Fax: 912-876-6566
Mary Judith Allen, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 303 Fraser Dr, Hinesville, GA 31313 Phone: 912-877-2227 Fax: 912-877-2332
Eric Lee Hall, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 512 S Main St Ste A, Hinesville, GA 31313 Phone: 912-369-5437 Fax: 912-369-5740
Mrs. Brittany Loretta Carter, FNP-BC Pediatrics Medicare: Medicare Enrolled Practice Location: 455 S Main St Ste 103, Hinesville, GA 31313 Phone: 912-876-6868 Fax: 912-876-6566
Douglas A Boudreau, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 303 Fraser Dr, Hinesville, GA 31313 Phone: 912-877-2227 Fax: 912-877-2332

Dr Nicole Stack Broerman, MD - Medicare Pediatrics in Hinesville, GA