Individual provider Active NPI

Bradley Christopher Hurliman, PA

  • Physician Assistant
  • West Lafayette, IN
National Provider Identifier
1144357740
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001021A Issued in IN
Practice address
124 Sagamore Pkwy West
West Lafayette, IN 47906
Phone
(765) 463-6722
Fax
(765) 463-0905
NPI assigned
Feb 28, 2007
Last updated
May 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 798 KY
Physician Assistant 363A00000X 10001021A IN Primary

Addresses

Primary practice location

124 Sagamore Pkwy West
West Lafayette, IN 47906

Mailing address

124 Sagamore Pkwy West
West Lafayette, IN 47906
Phone (765) 463-6722

Other identifiers 1

IdentifierTypeStateIssuer
000000495090OtherKYANTHEM ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20081024000224 IN Practitioner - Physician Assistant 9739247420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Randall Dermatology, PCGroup PAC ID 3678675329, 10 clinicians

Practice addresses (Care Compare)

124 Sagamore Pkwy W
West Lafayette, IN 47906-1569
Phone (765) 463-6722

1351 S Jackson St
Frankfort, IN 46041-3314
Phone (765) 659-3330

Merit-based Incentive Payment System (MIPS)

Final score
88.65 of 100Reported as group
Quality
91.4
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
798KYMDClinical Social Worker
10001021AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Albert C. Lee, M.D., P.C. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1144357740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SAGAMORE PKWY WEST",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "47906",
            "telephone_number": "765-463-6722",
            "fax_number": "765-463-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SAGAMORE PKWY WEST",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "47906",
            "telephone_number": "765-463-6722",
            "fax_number": "765-463-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLIMAN",
        "first_name": "BRADLEY",
        "middle_name": "CHRISTOPHER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "798",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001021A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID",
            "identifier": "000000495090",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lafayette, IN

Sources for this page

Verify at the official NPI Registry.