NPI 1497130702 · live from the CMS NPI Registry
Matthew Coury Broberg, O.D.
Optometrist in Lenexa, KS. National Provider Identifier 1497130702, active.
NPI record
| NPI | 1497130702 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 13803 W 82nd Ter, Lenexa, KS 66215 |
| Practice phone | 785-320-0998 |
| Enumerated | July 28, 2015 |
| Last updated | August 13, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 2015032220 (MO) |
| Optometrist | 152W00000X | 0003144 (CO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.