Kelly Clark Broderick, M.D.
NPI 1609821891ActiveIndividual· Radiology, Diagnostic Radiology· San Mateo, CA
Radiology, Diagnostic Radiology (M.D.) in San Mateo, California, trained at Harvard Medical School (class of 1992). Medicare paid $152,450 for services to 2,694 patients in 2024.
Overview
| NPI | 1609821891 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | No |
| NPI issued | May 24, 2006 |
| Last updated in NPPES | Sep 23, 2020 |
| Certified by provider | Sep 23, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Radiology, Diagnostic Radiology Primary | 2085R0202X | G78759 | CA |
| Radiology, Diagnostic Ultrasound | 2085U0001X | G78759 | CA |
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) | Enrolled Practitioner - Diagnostic Radiology (CA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 2,694 |
|---|---|
| Services billed | 4,789 across 122 procedure codes |
| Paid by Medicare | $152,450 |
Education and affiliations
| Medical school | Harvard Medical School |
|---|---|
| Graduation year | 1992 |
| Medicare specialty | Diagnostic Radiology |
Medical groups
- Sutter Bay Medical FoundationFremont, CA · 3,829 clinicians
- County of San MateoSan Mateo, CA · 310 clinicians
- California Advanced Imaging Medical Associates IncSan Francisco, CA · 88 clinicians
Hospital affiliations
- Peninsula Medical CenterBurlingame, CA
- San Mateo Medical CenterSan Mateo, CA
- Stanford Health CareStanford, CA
- Sutter Lakeside HospitalLakeport, CA
- UCSF Medical CenterSan Francisco, CA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Radiology, Diagnostic Radiology providers in San Mateo
- 1649778424
- 1255856183
- 1730711854
- 1003027806
- 1992170542
- 1538637889
- 1912425844
- 1356447627
- 1033162912
- 1285837906
- 1730452806
- 1932326188
All Radiology, Diagnostic Radiology providers in California →