Bradley A Blackburn, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

35053437 Issued in OH

Practice address

18181 Pearl Rd Ste A102
Strongsville, OH 44136-6951

Phone

(440) 816-4250

NPI assigned

Aug 24, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 9

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Diagnostic Radiology

Education

University of Vermont College of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Radiology Associates LLCGroup PAC ID 2769829522, 74 clinicians

West Virginia Radiology Associates PCGroup PAC ID 9133666431, 91 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Villages Regional Hospital, the Hospital, The Villages, FL, CCN 100290
• Uf Health Leesburg Hospital Hospital, Leesburg, FL, CCN 100084

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Radiology Associates LLC

  • Diagnostic Radiology Physician
  • Leesburg, FL
  • NPI 1497510978

  Diagnostic Radiology, FL

  Medicare reassignment Care Compare group NPD
• West Virginia Radiology Associates PC

  • Diagnostic Radiology Physician
  • Charleston, WV
  • NPI 1093550915

  Diagnostic Radiology, FL

  Medicare reassignment Care Compare group NPD
• Columbus Radiology Corp

  • Diagnostic Radiology Physician
  • Columbus, OH
  • NPI 1669408159

  Diagnostic Radiology, OH

  Medicare reassignment NPD
• Southwest General Medical Group Inc

  • Internal Medicine Physician
  • Cleveland, OH
  • NPI 1134239676

  OH

  Medicare reassignment NPD
• Vein Care of Ohio-West, LLC

  • General Practice Physician
  • Cleveland, OH
  • NPI 1104994219
  NPD (past) Authorized official
• Southwest General Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Middleburg HTS, OH
  • NPI 1588393979
  NPD
• Vpa PC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Boardman, OH
  • NPI 1235299926

  Diagnostic Radiology

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Leesburg Regional Medical Center Inc

  • Urgent Care Clinic/Center
  • Leesburg, FL
  • NPI 1245001189

  Hospital

  Care Compare affiliation
• Leesburg Regional Medical Center Inc

  • General Acute Care Hospital
  • Leesburg, FL
  • NPI 1245226190

  Hospital

  Care Compare affiliation
• LRMC Urgent Care Center

  • Urgent Care Clinic/Center
  • Leesburg, FL
  • NPI 1598841389

  Hospital

  Care Compare affiliation
• Villages Tri-County Medical Center Inc.

  • General Acute Care Hospital
  • The Villages, FL
  • NPI 1740276518

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1033102124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 638269",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452634455",
            "telephone_number": "440-816-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 PEARL RD STE A102",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366951",
            "telephone_number": "440-816-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "BRADLEY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35053437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMH",
            "identifier": "0304914",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4007005",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "414948",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE",
            "identifier": "740475",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000221054",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000511513",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000302578",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0629172",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00412281",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bblackburn@direct.swgeneral.com",
            "affiliation": "Y",
            "affiliationName": "Southwest General Medical Group Inc",
            "address_1": "18181 Pearl Rd Ste A102",
            "city": "Strongsville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441366951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Ross Biada
• Sharon Marie Bible
• Sarpreet Bindra, MD
• Binu Eapen DDS Inc.
• BKBG Enterprises LLC
• Danielle Lorinda Blase, COTA
• Samantha Blashinsky
• Thomas Gregory Blatnik
• Carrie Lynn Blum, COTA-L
• Jan M. Bohonek, D.D.S.

• All providers in Strongsville, OH
• Diagnostic Radiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.