Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Kelly Clark Broderick, M.D.

Diagnostic Radiology Physician in San Mateo, CA · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1609821891

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Registry record

Entity type Individual (Type 1)

Name Kelly Clark Broderick

Credential M.D.

Sex Female

Practice address 100 S San Mateo Dr, San Mateo, CA, 94401

Phone (650) 696-4515

Fax (650) 696-4626

Enumeration date May 24, 2006

Last updated in NPPES Sep 23, 2020

Taxonomy & licenses

2085U0001X Diagnostic Ultrasound Physician Allopathic & Osteopathic Physicians · License G78759 (CA) Secondary

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians · License G78759 (CA) Primary

MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier	Type	State	Issuer
00G787590	Medicaid	CA	-
300121792	Other	CA	RAILROAD MEDICARE
00G787590	Other	CA	BLUE CROSS
300121755	Other	CA	RAILROAD MEDICARE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where does Kelly Broderick practice?

The practice location on file with NPPES is in San Mateo, CA. Providers can have multiple locations; NPPES lists the primary practice address.

What is the NPI number for Kelly Broderick?

The National Provider Identifier (NPI) for Kelly Broderick is 1609821891, a Type 1 (individual) record in the CMS NPPES registry.

Other providers at this practice address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-09-23.