Individual provider Active NPI

Ann Marie Daly Bradley, CRNP

  • Acute Care Nurse Practitioner
  • Broomall, PA
National Provider Identifier
1114758729
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP030369 Issued in PA
Practice address
30 Lawrence Rd Ste 201
Broomall, PA 19008-3301
Phone
(610) 492-5911
NPI assigned
Aug 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP030369 PA Primary

Addresses

Primary practice location

30 Lawrence Rd Ste 201
Broomall, PA 19008-3301

Mailing address

206 Pomona Ave
Newtown Square, PA 19073-3141
Phone (610) 633-7772

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250730000392 PA Practitioner - Nurse Practitioner 7618484072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Consultants in Medical Oncology and Hematology PCGroup PAC ID 2365413127, 9 clinicians

Practice addresses (Care Compare)

30 Lawrence Rd
Suite 201
Broomall, PA 19008-3301
Phone (610) 492-5900

Hospital & facility affiliations

  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP030369PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Palliative Care, PC CurrentSince Aug 18, 2024 Accepting new patients
Consultants in Medical Oncology & Hematology, PC CurrentSince Apr 28, 2025 Accepting new patients

Locations

30 Lawrence Rd
Ste 201
Broomall, PA 19008
Phone (610) 492-5900

500 Evergreen Dr
Ste G4
Glen Mills, PA 19342
Phone (610) 887-0303

3855 West Chester Pike
Ste 101
Newtown Square, PA 19073

3855 West Chester Pike
Fl Cancer
Newtown Square, PA 19073

3855 West Chester Pike
Newtown Square, PA 19073
Phone (484) 337-6000

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1114758729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 POMONA AVE",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190733141",
            "telephone_number": "610-633-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LAWRENCE RD STE 201",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083301",
            "telephone_number": "610-492-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "ANN MARIE",
        "middle_name": "DALY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP030369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

Verify at the official NPI Registry.