Individual provider Active NPI

Bradley Klement, PA-C

  • Physician Assistant
  • Columbia, MD
National Provider Identifier
1053698266
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0008879 Issued in MD
Practice address
10710 Charter Dr
Columbia, MD 21044-3128
Phone
(410) 955-5000
NPI assigned
Nov 16, 2011
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09183 TX
Physician Assistant 363A00000X PA9106331 FL
Physician Assistant 363A00000X C0008879 MD Primary

Addresses

Primary practice location

10710 Charter Dr
Columbia, MD 21044-3128

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (239) 343-0550

Other practice location 1

13340 Metro Parkway
Suite 200
Fort Myers, FL 33966-4703
Phone (239) 343-0550

Other identifiers 2

IdentifierTypeStateIssuer
004312000MedicaidFL
341221501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719003890 MD Practitioner - Physician Assistant 2163697855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10710 Charter Dr
Suite 400
Columbia, MD 21044-3276
Phone (410) 997-7979

1300 York Rd
Suite 30D
Lutherville, MD 21093-6090
Phone (443) 275-1337

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.02 of 100Reported as group
Quality
65.13
Promoting interoperability
98
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0008879MDMDPhysician Assistant
PA09183TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Regional Physicians LLC CurrentSince Aug 1, 2024 Accepting new patients
St Agnes Healthcare Inc CurrentSince Aug 7, 2023 Accepting new patients
Johns Hopkins Regional Physicians LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

10710 Charter Dr
Ste 400
Columbia, MD 21044
Phone (410) 997-7979

1300 York Rd
Ste 30D
Lutherville Timonium, MD 21093
Phone (443) 275-1337

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: bklement1272674@direct.hopkinsmedicine.org

Organizations & group practices 5

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1053698266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "239-343-0550",
            "fax_number": "239-343-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 CHARTER DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443128",
            "telephone_number": "410-955-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13340 Metro Parkway",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339664703",
            "country_code": "US",
            "telephone_number": "239-343-0550",
            "fax_number": "239-343-0559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEMENT",
        "first_name": "BRADLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09183",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106331",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004312000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341221501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.