Candice Lillian Brady, DO
Individual provider Active NPI Orthopaedic Foot and Ankle Surgery Physician · Camarillo, CA
NPI 1124368667 · NPPES record last updated Feb 11, 2020
Key facts
- NPI
- 1124368667
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Foot and Ankle Surgery Physician 207XX0004X
- License
- 20A14792 (CA)
- Practice address
- 400 Camarillo Ranch Rd Ste 101
Camarillo, CA 93012-5901 - Phone
- (805) 273-5478
- Fax
- (805) 852-2688
- NPI assigned
- Feb 20, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- Michigan State University College of Human Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
400 Camarillo Ranch Rd
Suite 101
Camarillo, CA 93012-5901
Phone (805) 273-5478
Hospital & facility affiliations
- St Johns Regional Medical Center
- Adventist Health Simi Valley
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200313001440 | CA | Practitioner - Orthopedic Surgery | 3577810753 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A14792 | CA | MD | Orthopaedic Foot and Ankle Surgery Physician |
| DO2364 | NV | MD | Orthopaedic Foot and Ankle Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Candice Brady DO PC | Single Specialty | Current |
Accepting new patients |
Locations
400 Camarillo Ranch Rd
Ste 101
Camarillo, CA 93012
Phone (805) 273-5478
Interoperability endpoints
- candice.brady.1@28093.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Foot and Ankle Surgery Physician | 207XX0004X | DO2364 | NV | |
| Orthopaedic Foot and Ankle Surgery Physician |
207XX0004X | 20A14792 | CA | Yes |
Addresses
Primary practice location
400 Camarillo Ranch Rd Ste 101
Camarillo, CA 93012-5901
Mailing address
400 Camarillo Ranch Rd Ste 101
Camarillo, CA 93012-5901
Phone (805) 273-5478
Other practice location 1
2930 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5059
Phone (702) 263-9082
Other practice location 2
8205 W Warm Springs Rd Ste 250
Las Vegas, NV 89113-3646
Phone (702) 227-2152
Other practice location 3
2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121
Phone (702) 731-1616
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DO2364 | Other | NV | NV LICENSE |
Other providers in Camarillo, CA
- Charleen Boucher
- Andrea Claire Bower
- Olivia Boyd
- Dwayne Bozeman Jr.
- Sarah Bradshaw
- Robin Colleen Shannon Brady
- Sarah Katharine Braid
- Sabrina Brana
- Lisa Elaine Brand
- Ronald James Brand
All providers in Camarillo, CA · Orthopaedic Foot and Ankle Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.