Dominique Broadnax, PSYD
NPI 1679205074 · Clinical Psychologist · Boston, MA
Enrolled with Medicare as Practitioner - Clinical Psychologist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Dominique Broadnax, PSYD is a Clinical Psychologist provider in Boston, MA (NPI 1679205074).
Provider details
- NPI number
- 1679205074
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PSYD
- Sex
- Female
- Sole proprietor
- No
- License
- PS02359 (RI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
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
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
- 2022-06-26
- Last updated
- 2025-10-21
- Certified
- 2025-10-21
Frequently asked questions
- What is Dominique Broadnax's NPI number?
- Dominique Broadnax's National Provider Identifier (NPI) is 1679205074, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Dominique Broadnax's specialty?
- Dominique Broadnax is listed in the NPPES registry with a primary specialty of Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Dominique Broadnax located?
- Dominique Broadnax's practice location on file with NPPES is 75 Fenwood Rd, Boston, MA 02115-6103.
- What is Dominique Broadnax's phone number?
- The practice phone number listed in the NPPES registry for Dominique Broadnax is (617) 626-9300.
- Does Dominique Broadnax accept Medicare?
- Dominique Broadnax is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Dominique Broadnax's NPI active?
- Yes — Dominique Broadnax's NPI (1679205074) is active in the NPPES registry as of the last update on 2025-10-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.