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

John Broderick, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1710627070

John Broderick, MD is a Psychiatry in Phoenix, Arizona. Qualified in 2022, 4 years ago. Practices as a sole proprietor. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone: (602) 933-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 74541 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1710627070
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 1, 2022
Last updated in NPPESJuly 16, 2025
Certification dateJuly 16, 2025
Mailing address1300 N 12th St Ste 320, Phoenix, AZ 85006-2858

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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