Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lydia Elizabeth Broussard, PA-C

Individual provider Physician Assistant · NPI 1104572478

Lydia Elizabeth Broussard, PA-C is a Physician Assistant in Anchorage, Alaska. Qualified in 2021, 5 years ago. Practices with Select Physical Therapy Holdings Inc, a 2,121-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Alaska and Texas.

Years since qualifying
5
Licensed in
AK, TX
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2925 Debarr Rd Ste 240
Anchorage, AK 99508-2959
Phone: (907) 339-4650
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 221587 (AK)
Physician Assistant Taxonomy 363A00000X · Licence PA15445 (TX)

Record details

NPI number1104572478
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 25, 2022
Last updated in NPPESAugust 6, 2026
Certification dateAugust 6, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Select Physical Therapy Holdings Inc — 2121 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Anchorage