Kevin Broderick
NPI 1639449721ActiveIndividual· Ophthalmology, Retina Specialist· Bethesda, MD
Ophthalmology, Retina Specialist in Bethesda, Maryland, licensed in MD, DC and VA, with an NPI issued in January 2012. Enrolled in Medicare as practitioner - ophthalmology.
Overview
| NPI | 1639449721 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | Yes |
| NPI issued | Jan 5, 2012 |
| Last updated in NPPES | Mar 21, 2025 |
| Certified by provider | Mar 21, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Ophthalmology, Retina Specialist Primary | 207WX0107X | D84883 | MD |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | — |
| Ophthalmology | 207W00000X | MD045933 | DC |
| Ophthalmology, Retina Specialist | 207WX0107X | 0101264466 | VA |
| Ophthalmology, Retina Specialist | 207WX0107X | MD45933 | DC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Ophthalmology (DC) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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