{"npi":"1407804834","type":"NPI-1","status":"active","name":{"display":"Dr. Bethany Broderick MD","other":[],"first":"BETHANY","last":"BRODERICK","middle":"A","credential":"MD"},"specialty":{"primary_taxonomy":"208000000X","primary_taxonomy_description":"Pediatrics","slug":"pediatrics","schema_org_specialty":"Pediatric","all":[{"code":"208000000X","description":"Pediatrics","primary":true,"state":"NY","license":"239752"}]},"addresses":[{"purpose":"LOCATION","street_1":"1044 STATE ST","city":"SCHENECTADY","state":"NY","postal_code":"123071508","country_code":"US","phone":"5183701441","fax":"5183959431"},{"purpose":"MAILING","street_1":"1044 STATE ST","city":"SCHENECTADY","state":"NY","postal_code":"123071508","country_code":"US","phone":"5183701441","fax":"5183959431"}],"license":{"state":"NY","number":"239752"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"02756527","state":"NY","issuer":null},{"type_code":"05","label":"Medicaid","value":"02995513","state":"NY","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20061030000582","type_code":"14-37","type_desc":"PRACTITIONER - PEDIATRIC MEDICINE","state":"NY","pac_id":"1052318375"}]},"enumeration_date":"2006-05-05","last_updated":"2009-08-19","_meta":{"source":"NPPES","snapshot_date":"2009-08-19","doc_url":"https://findmynpi.com/api"}}