NPIMap

Individual provider Active NPI

Jason Thomas Bradley, M.D.

  • Interventional Cardiology Physician
  • Lubbock, TX
National Provider Identifier
1073677977
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
L1532 Issued in TX
Practice address
4321 Marsha Sharp Fwy
Lubbock, TX 79407-2504
Phone
(806) 686-3500
Fax
(806) 701-4973
NPI assigned
Dec 22, 2006
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X L1532 TX Primary

Addresses

Primary practice location

4321 Marsha Sharp Fwy
Lubbock, TX 79407-2504

Mailing address

4324 23Rd St
Lubbock, TX 79410-1812
Phone (806) 686-3500

Other practice location 1

4324 23rd St
Lubbock, TX 79410-1812
Phone (806) 686-3500

Other identifiers 3

IdentifierTypeStateIssuer
14984032MedicaidNM
148315812MedicaidTX
P01690378OtherRAILROAD MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040526000812 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Interventional Cardiology 0648251678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Interventional Cardiology
Education
Texas Tech University Health Science Center School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Texas Heart and Vascular PLLCGroup PAC ID 6305297763, 4 clinicians

Practice addresses (Care Compare)

4321 Marsha Sharp Fwy
Lubbock, TX 79407-2504
Phone (806) 701-4263

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting68
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)76

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Heart & Vascular, PLLC Interventional Cardiology CurrentSince Nov 28, 2023 Accepting new patients
Howard Emergency Medicine Associates PA. Past Accepting new patients
LHH Emergency Physicians PLLC Past Accepting new patients

Locations

4321 Marsha Sharp Fwy
Lubbock, TX 79407
Phone (806) 701-5858

4324 23rd St
Lubbock, TX 79410
Phone (806) 701-4263

Interoperability endpoints

  • Direct secure messaging: jason.bradley@direct.myteamcare.com

Organizations & group practices 3

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 10

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1073677977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4324 23RD ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101812",
            "telephone_number": "806-686-3500",
            "fax_number": "806-701-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072504",
            "telephone_number": "806-686-3500",
            "fax_number": "806-701-4973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4324 23rd St",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794101812",
            "country_code": "US",
            "telephone_number": "806-686-3500",
            "fax_number": "806-701-4973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JASON",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "L1532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14984032",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148315812",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "P01690378",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.