Individual provider Active NPI

Bradly Lantz, PA

  • Physician Assistant
  • Vestal, NY
National Provider Identifier
1063988723
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4417 Vestal Pkwy E
Vestal, NY 13850-3556
Phone
(607) 729-2144
Fax
(607) 729-2145
NPI assigned
Oct 22, 2018
Last updated
Oct 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

4417 Vestal Pkwy E
Vestal, NY 13850-3556

Mailing address

33 Lewis Rd
2ND FL
Binghamton, NY 13905
Phone (607) 729-8156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181219000047 NY Practitioner - Physician Assistant 6507101656 Reassigns benefits to 3 organizations
I20220125002124 PA Practitioner - Physician Assistant 6507101656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Guthrie Medical Group PCGroup PAC ID 6002728656, shared by 5 NPIs, 795 clinicians

Practice addresses (Care Compare)

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

110 Plaza LN
Wellsboro, PA 16901-1773
Phone (570) 724-4241

130 Ctr Way
Corning, NY 14830-2255
Phone (607) 936-9971

1336 Cedar St
Elmira, NY 14904-2951
Phone (607) 734-3929

1780 Hanshaw Rd
Ithaca, NY 14850-9105
Phone (607) 257-5858

2517 Vestal Pkwy E
Vestal, NY 13850-2020
Phone (607) 798-1452

275 Guthrie Dr
Troy, PA 16947-8115
Phone (570) 297-2121

285 Guthrie Dr
Troy, PA 16947-8115
Phone (570) 297-4104

31 Arnot Rd
A
Horseheads, NY 14845-8533
Phone (607) 795-5100

One Guthrie SQ
Sayre, PA 18840-1625

One Guthrie Square
Sayre, PA 18840-1625

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
022999NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, LTD. CurrentSince Jan 17, 2022 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jan 17, 2022 Accepting new patients
Guthrie Medical Group, P.C. CurrentSince Jan 17, 2022 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C, Current Accepting new patients
United Medical Associates, P.C. CurrentSince Dec 17, 2018 Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
Guthrie Medical Group, P.C. Current Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Dec 17, 2018 Accepting new patients
Guthrie Medical Group PC Past Accepting new patients

Locations

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

130 Center Way
Corning, NY 14830
Phone (607) 936-9971

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

4417 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 729-2144

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

132 Colonial Dr
Towanda, PA 18848
Phone (570) 265-6165

110 Plaza Ln
Wellsboro, PA 16901
Phone (570) 724-4241

Interoperability endpoints

  • Direct secure messaging: blantz171035@direct-guthrie.org

Organizations & group practices 12

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 6

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": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1063988723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD",
            "address_2": "2ND FL",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-729-8156",
            "fax_number": "607-729-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503556",
            "telephone_number": "607-729-2144",
            "fax_number": "607-729-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANTZ",
        "first_name": "BRADLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestal, NY

Sources for this page

Verify at the official NPI Registry.