Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Broadstone Medical, PC

Organization General Practice Physician · NPI 1366165359

Broadstone Medical, PC is a General Practice Physician in Lake Elmo, Minnesota. Works from 2 locations. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8530 Eagle Point Blvd Ste 100
Lake Elmo, MN 55042-8648
Phone: (231) 432-5841
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 500 Ala Moana Blvd Ste 7400, Honolulu, HI 96813-4902 — (904) 728-6493

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1366165359
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nancy Herrera — Clinical Operations Manager · (920) 915-6995
NPI enumeratedSeptember 23, 2022
Last updated in NPPESMarch 26, 2026
Certification dateMarch 26, 2026
Mailing address222 Lakeview Ave Ste 735, West Palm Beach, FL 33401-6145