Bradley Steven Mummert, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.005239RX Issued in OH

Practice address

3333 Burnet Ave
MLC 2004
Cincinnati, OH 45229-3026

Phone

(513) 636-4770

Fax

(513) 636-3847

NPI assigned

Sep 12, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Children'S Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784

  Physician Assistant

  Medicare reassignment NPD
• Mercy Health Physicians Cincinnati LLC

  • Durable Medical Equipment & Medical Supplies
  • Liberty Township, OH
  • NPI 1790281517
  NPD
• Mercy Health Physicians Cincinnati, LLC

  • Family Medicine Physician
  • Blue Ash, OH
  • NPI 1205887023

  Physician Assistant

  NPD
• Lexington County Health Services District, Inc.

  • Surgery Physician
  • West Columbia, SC
  • NPI 1215955174
  NPD (past)
• Lexington County Health Services District, Inc.

  • Radiology Clinic/Center
  • Columbia, SC
  • NPI 1811922164
  NPD (past)
• Lexington Medical Center

  • General Acute Care Hospital
  • West Columbia, SC
  • NPI 1831550060
  NPD (past)

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1124576814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 2004",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4770",
            "fax_number": "513-636-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 2004",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-4770",
            "fax_number": "513-636-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMMERT",
        "first_name": "BRADLEY",
        "middle_name": "STEVEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-12",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50005239RX",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "2611",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005239RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James J. Mulloney Jr., RN, CNP
• Elena Mulready, DPT
• Megan Dorothy Mulvaney, SLP
• Kari Marie Mumaw
• Jonathan Mumma, MD
• Donsha Mumphrey, STNA, LPN
• Jeffrey Cole Mumpower, CAA
• James Muncy, ATC, AT
• Rino Munda, MD
• Letitia Munday, RN

• Physician Assistant in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.