MICHAEL D BROADWELL PSY.D
NPI 1053645119
Psychologist in Rochester, MN
NPI Status: Active since September 22, 2009
Contact Information
3535 40TH AVE NW STE 210
ROCHESTER, MN
ZIP 55901
Phone: (507) 516-0227
Fax: (507) 516-0228
- Individual
- Male
- Psychologist
- PECOS Enrolled
About MICHAEL BROADWELL
This page provides the complete NPI Profile along with additional information for Michael Broadwell, a provider established in Rochester, Minnesota with a medical specialization in Psychologist. The healthcare provider is registered in the NPI registry with number 1053645119 assigned on September 2009. The practitioner's primary taxonomy code is 103T00000X with license number LP6869 (MN). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1053645119
- Provider Name
- MICHAEL D BROADWELL PSY.D
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901
- Location Phone
- (507) 516-0227
- Location Fax
- (507) 516-0228
- Mailing Address
- 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901
- Mailing Phone
- (507) 516-0227
- Mailing Fax
- (507) 516-0228
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-22-2009
- Last Update Date
- 12-12-2022
- Code Navigator
A psychologist like Michael Broadwell studies cognitive, emotional, social processes and behavior by observing, interpreting, and recording how people relate to one another and to their environments. Psychologists gather information and evaluate behavior through controlled laboratory experiments, psychoanalysis, psychotherapy or through personality, performance, aptitude, or intelligence tests, and use this information when testing theories in their research or when treating patients.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist
- Taxonomy Code
- 103T00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- LP6869
- License State
- MN
- Taxonomy Description
- A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | |
| 3 | 103T00000X | Behavioral Health & Social Service Providers | Psychologist |
Medicare Participation & PECOS Enrollment Status
Michael Broadwell is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 5 | 3 | 6 | 4 | 5 | 1 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 10 | 3 | 12 | 4 | 10 | 1 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 1 + 0 + 3 + 1 + 2 + 4 + 1 + 0 + 1 + 2 + 24 = 41 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 41 = 9 | 9 | ||||||||
The NPI number 1053645119 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 11 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1083006589 | MRS. KARA JEANE PEDERSON LGSW Individual | Social Worker (Clinical) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 516-0227 |
| 1518668375 | HEATHER GRACE BOWEN Individual | Counselor (Professional) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 516-0227 |
| 1891567830 | JENNIFER BLOMBERG MSW, LGSW, LADC Individual | Social Worker (Clinical) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 516-0277 |
| 1639911720 | SHAYLA AUBREY JANZEN-LEBEOUF Individual | Counselor (Professional) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 428-7154 |
| 1790523900 | EMILY ROSE BINGHAM Individual | Counselor (Professional) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 516-0227 |
| 1396573911 | HOPE SARAH WICKERT MS Individual | Counselor (Professional) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 707-8309 |
| 1629806864 | KATHERINE ANN FLEMING MSW Individual | Social Worker (Clinical) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 369-6488 |
| 1346061272 | MRS. KELLEY GAMMELL MA Individual | Counselor (Professional) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 516-0227 |
| 1831909175 | SUSAN JANE HEMMESCH Individual | Social Worker (Clinical) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 516-0227 |
| 1083415178 | YEE YENG LAU Individual | Counselor (Professional) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 516-0227 |
| 1649993387 | MRS. STEPHANIE MARIE LEWERKE MS, LPCC Individual | Counselor (Mental Health) | 3535 40TH AVE NW STE 210 ROCHESTER, MN 55901 (507) 516-0227 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053645119, enumerated in the NPI registry as an "individual" on September 22, 2009
The provider is located at 3535 40th Ave Nw Ste 210 Rochester, Mn 55901 and the phone number is (507) 516-0227
The provider's speciality is Psychologist with taxonomy code 103T00000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME).
This NPI record was last updated on September 22, 2009. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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