Individual provider Active NPI

Richard Brannon Claytor, MD

  • Plastic and Reconstructive Surgery Physician
  • Bryn Mawr, PA
National Provider Identifier
1114035995
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD443747 Issued in PA
Practice address
135 S Bryn Mawr Ave Ste 300
Bryn Mawr, PA 19010-3131
Phone
(610) 527-4833
Fax
(610) 527-7403
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 016864 ME
Surgery of the Hand (Surgery) Physician 2086S0105X 016864 ME
Plastic and Reconstructive Surgery Physician 2086S0122X MD443747 PA Primary

Addresses

Primary practice location

135 S Bryn Mawr Ave Ste 300
Bryn Mawr, PA 19010-3131

Mailing address

135 S Bryn Mawr Ave Ste 300
Bryn Mawr, PA 19010-3131
Phone (610) 527-4833

Other identifiers 1

IdentifierTypeStateIssuer
431882299MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150202001694 PA Practitioner - Plastic and Reconstructive SurgeryPractitioner - Hand Surgery 1153350525

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
016864MEMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wachusett Emergency Physicians, PC Past Accepting new patients

Organizations & group practices 1

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1114035995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE STE 300",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103131",
            "telephone_number": "610-527-4833",
            "fax_number": "610-527-4803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S BRYN MAWR AVE STE 300",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103131",
            "telephone_number": "610-527-4833",
            "fax_number": "610-527-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTOR",
        "first_name": "RICHARD",
        "middle_name": "BRANNON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "ME",
            "license": "016864",
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "ME",
            "license": "016864",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "PA",
            "license": "MD443747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431882299",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.