Individual provider Active NPI

Bradley Jon Haupricht Jr., M.D.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1083876981
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01069000A Issued in IN
Practice address
64 Bleecker St # 151
New York, NY 10012-2410
Phone
(313) 509-8683
NPI assigned
Jul 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01069000A IN Primary

Addresses

Primary practice location

64 Bleecker St # 151
New York, NY 10012-2410

Mailing address

64 Bleecker St # 151
New York, NY 10012-2410
Phone (313) 509-8683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, CT, GA3 enrollments
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.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20120810000419 VA Practitioner - Family Practice 1052597416 Reassigns benefits to 1 organization
I20241126001752 CT Practitioner - Family Practice 1052597416
I20241211003346 GA Practitioner - Family Practice 1052597416 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01069000AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galileo Medical Group Ga, P.C. Family Medicine CurrentSince Sep 8, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Nov 3, 2016 Accepting new patients
Privia Medical Group, LLC Family Medicine CurrentSince Nov 3, 2016 Accepting new patients
Icem-Ball, LLC Past Accepting new patients

Locations

4300 Paces Ferry Rd SE
Ste 500
Atlanta, GA 30339
Phone (404) 496-8960

64 Bleecker St
New York, NY 10012
Phone (302) 313-1584

1971 University Blvd
Lynchburg, VA 24515
Phone (434) 582-2000

14005 Wards Rd
Lynchburg, VA 24501
Phone (434) 239-0132

2019 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 845-7035

1971 University Blvd
Ste 1895
Lynchburg, VA 24515
Phone (434) 338-7774

2321 Wards Rd
Lynchburg, VA 24502
Phone (434) 582-2273

8644 Sudley Rd
#220
Manassas, VA 20110

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: bradley.haupricht@450368864321540.direct.elationemr.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1083876981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BLEECKER ST # 151",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122410",
            "telephone_number": "313-509-8683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BLEECKER ST # 151",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122410",
            "telephone_number": "313-509-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUPRICHT",
        "first_name": "BRADLEY",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01069000A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.