Individual provider Active NPI

Bradley Pulver, MD

  • Emergency Medicine Physician
  • Manahawkin, NJ
National Provider Identifier
1104901537
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA068954 Issued in NJ
Practice address
1140 Route 72 W
Manahawkin, NJ 08050-2412
Phone
(609) 978-8960
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA068954 NJ Primary

Addresses

Primary practice location

1140 Route 72 W
Manahawkin, NJ 08050-2412

Mailing address

22 Windward Dr
Manahawkin, NJ 08050-3339

Other identifiers 2

IdentifierTypeStateIssuer
25MA068954OtherNJSTATE LICENSE
DO7600000OtherNJSTNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051020000547 NJ Practitioner - Emergency Medicine 5496771230 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA068954NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC Past Accepting new patients
Englewood Medical Associates Inc Emergency Medicine Past Accepting new patients
Englewood Medical Associates, Inc Emergency Medicine Past Accepting new patients
Englewood Medical Associates Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104901537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 WINDWARD DR",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080503339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 ROUTE 72 W",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502412",
            "telephone_number": "609-978-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULVER",
        "first_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA068954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "25MA068954",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STNA",
            "identifier": "DO7600000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

Verify at the official NPI Registry.