Broadstone Medical, P.C.
NPI 1366165359 · General Practice Physician · Lake Elmo, MN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Broadstone Medical, P.C. is a General Practice Physician organization in Lake Elmo, MN (NPI 1366165359).
Provider details
- NPI number
- 1366165359
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Nancy Herrera, Clinical Operations Manager(920) 915-6995
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
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
Additional practice locations (1)
- 500 Ala Moana Blvd Ste 7400Honolulu, HI 96813-4902Phone: (904) 728-6493
Registry dates
- Enumerated
- 2022-09-23
- Last updated
- 2026-03-26
- Certified
- 2026-03-26
Frequently asked questions
- What is Broadstone Medical, P.C.'s NPI number?
- Broadstone Medical, P.C.'s National Provider Identifier (NPI) is 1366165359, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Broadstone Medical, P.C.?
- Broadstone Medical, P.C. is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Broadstone Medical, P.C. located?
- Broadstone Medical, P.C.'s practice location on file with NPPES is 8530 Eagle Point Blvd Ste 100, Lake Elmo, MN 55042-8648.
- What is Broadstone Medical, P.C.'s phone number?
- The practice phone number listed in the NPPES registry for Broadstone Medical, P.C. is (231) 432-5841.
- Does Broadstone Medical, P.C. accept Medicare?
- Broadstone Medical, P.C. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Broadstone Medical, P.C.?
- The authorized official listed on Broadstone Medical, P.C.'s NPPES record is Nancy Herrera, Clinical Operations Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Broadstone Medical, P.C.'s NPI active?
- Yes — Broadstone Medical, P.C.'s NPI (1366165359) is active in the NPPES registry as of the last update on 2026-03-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.