Active NPI
Bradlee G Drabant, M.D.
- Neonatal-Perinatal Medicine Physician
- Worcester, MA
National Provider Identifier
1114959657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 229233
- Practice address
- 55 Lake Ave N
Dept of Pediatrics
Worcester, MA 01655-0002 - Phone
- (774) 442-3951
- Fax
- (508) 856-6740
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 229233 | MA | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 229233 | MA | Primary |
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 229233 | MA |
Addresses
Primary practice location
55 Lake Ave N
Dept of Pediatrics
Worcester, MA 01655-0002
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111031000622 | CA | Order and Referring Only - Pediatric Medicine | 2365531712 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summerlin Hospital Medical Center L L C | 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.
-
- General Acute Care Hospital
- Las Vegas, NV
- NPI 1831189638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304380800000",
"number": "1114959657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415348",
"telephone_number": "800-225-8885",
"fax_number": "508-334-1977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"address_2": "DEPT OF PEDIATRICS",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "774-442-3951",
"fax_number": "508-856-6740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRABANT",
"first_name": "BRADLEE",
"middle_name": "G",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2011-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "229233",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "MA",
"license": "229233",
"primary": true
},
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "MA",
"license": "229233",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.