Broadstone Medical, P.C.
NPI 1366165359ActiveOrganization· General Practice· Lake Elmo, MN
General Practice in Lake Elmo, Minnesota, registered in NPPES in September 2022. The authorized official on file is Nancy Herrera, Clinical Operations Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1366165359 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 23, 2022 |
| Last updated in NPPES | Mar 26, 2026 |
| Certified by provider | Mar 26, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|