Kevin Broder, MD
NPI 1205885902 · Plastic Surgery Physician · San Diego, CA
Enrolled with Medicare as Order and Referring Only - Plastic and Reconstructive Surgery · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kevin Broder, MD is a Plastic Surgery Physician provider in San Diego, CA (NPI 1205885902).
Provider details
- NPI number
- 1205885902
- Entity type
- Individual
- Primary specialty
- Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- A82409 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-05-09
- Last updated
- 2012-09-05
Frequently asked questions
- What is Kevin Broder's NPI number?
- Kevin Broder's National Provider Identifier (NPI) is 1205885902, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kevin Broder's specialty?
- Kevin Broder is listed in the NPPES registry with a primary specialty of Plastic Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Kevin Broder located?
- Kevin Broder's practice location on file with NPPES is 4510 Executive Drive, San Diego, CA 92121.
- What is Kevin Broder's phone number?
- The practice phone number listed in the NPPES registry for Kevin Broder is (858) 453-7224.
- Does Kevin Broder accept Medicare?
- Kevin Broder is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kevin Broder's NPI active?
- Yes — Kevin Broder's NPI (1205885902) is active in the NPPES registry as of the last update on 2012-09-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.