Mazdak Moghaddam Bradberry, MD, PHD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

325382 Issued in NY

Practice address

1051 Riverside Dr
New York, NY 10032-1007

Phone

(412) 759-6215

NPI assigned

Apr 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Psychiatry

Education

University of Wisconsin School of Medicine, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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

{
    "created_epoch": "1650153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1033852173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 RIVERSIDE DR # 103",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 RIVERSIDE DR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321007",
            "telephone_number": "412-759-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBERRY",
        "first_name": "MAZDAK",
        "middle_name": "MOGHADDAM",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-17",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "325382",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew R Brackman, MD
• Conner Bracy, MD
• Keith Emanuel Bracy, D.D.S.
• Niles Bracy, PT, DPT
• Brad J. Jacobs, MD.PC
• Niyah Alise Bradberry
• Michelle S Bradbury, MD, PHD
• Mary Elizabeth Braddock, PH.D.
• Tanaeja Braddox
• Mary Ellen Brademas, MD

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.