NPIMap

Individual provider Active NPI

Bradley Fogel, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Little Rock, AR
National Provider Identifier
1043500804
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
E-9043 Issued in AR
Practice address
4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone
(501) 686-8000
NPI assigned
Apr 13, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X E-9043 AR Primary

Addresses

Primary practice location

4301 W Markham St # 783
Little Rock, AR 72205-7101

Mailing address

4301 W Markham St # 783
Little Rock, AR 72205-7101
Phone (501) 686-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150625001473 AR Practitioner - Pathology 0749506236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of North Texas HSC, College of Osteopathic Med, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Pathology Associates PAGroup PAC ID 8921905589, 10 clinicians

Practice addresses (Care Compare)

2 Saint Vincent Cir
Little Rock, AR 72205-5423
Phone (501) 663-4116

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E-9043ARMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Pathology Associates PA Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2016 Accepting new patients

Locations

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

1000 N University Ave
Little Rock, AR 72207
Phone (501) 661-0060

Organizations & group practices 1

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.

Hospital & facility affiliations 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436486400000",
    "number": "1043500804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 783",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGEL",
        "first_name": "BRADLEY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-13",
        "last_updated": "2015-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "E-9043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.