Kaylie Broberg
NPI 1053824748ActiveIndividual· Marriage & Family Therapist· Plymouth, MN
Opted out of Medicare from January 2024 to January 2028. Marriage & Family Therapist in Plymouth, Minnesota, licensed in MN, with an NPI issued in November 2017.
Overview
| NPI | 1053824748 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Nov 16, 2017 |
| Last updated in NPPES | Dec 28, 2021 |
| Certified by provider | Nov 29, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Marriage & Family Therapist Primary | 106H00000X | 3775 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Jan 1, 2024 – Jan 1, 2028 |
| Can order and refer | No |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
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