Individual provider Active NPI

Azore-Dee Bradshaw, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Milwaukee, WI
National Provider Identifier
1154682250
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
101305 Issued in WI
Practice address
9200 W Wisconsin Avenue
Department of Pathology
Milwaukee, WI 53226-3522
Phone
(414) 805-6966
Fax
(414) 805-6980
NPI assigned
Jun 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 101305 WI Primary

Addresses

Primary practice location

9200 W Wisconsin Avenue
Department of Pathology
Milwaukee, WI 53226-3522

Mailing address

9200 W Wisconsin Avenue
Department of Pathology
Milwaukee, WI 53226-3522
Phone (414) 805-6966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250327002350 NY Practitioner - Pathology 3173924503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Ohio State University College of Medicine, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

187 Hwy 36
Suite 230
West Long Branch, NJ 07764

Merit-based Incentive Payment System (MIPS)

Final score
87.99 of 100Reported as group
Quality
82.81
Promoting interoperability
100
Improvement activities
40
Cost
77.15

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
101305WIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Digestive Health, LLC CurrentSince Mar 1, 2021 Accepting new patients
Meridian Laboratory Physicians PA Anatomic Pathology & Clinical Pathology CurrentSince Jun 3, 2024 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Dec 1, 2023 Accepting new patients
Premier Medical Group of the Hudson Valley, P.C. CurrentSince May 1, 2025 Accepting new patients
Premier Medical Group of the Hudson Valley P.C. CurrentSince May 1, 2025 Accepting new patients
Atlantic Coast Gastroenterology Associates Past Accepting new patients

Locations

727 N Beers St
Holmdel, NJ 07733
Phone (732) 714-2700

365 Broad St
Ste 2E
Red Bank, NJ 07701
Phone (732) 222-3805

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

365 Broad St
Ste 1E
Red Bank, NJ 07701
Phone (732) 842-4294

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

1640 Route 88 W
Ste 202
Wall Township, NJ 08724
Phone (732) 370-2220

187 State Route 36
Ste 230
West Long Branch, NJ 07764
Phone (732) 222-3805

50 Eastdale Ave N
Poughkeepsie, NY 12603
Phone (845) 437-5000

243 North Rd
Ste 304
Poughkeepsie, NY 12601
Phone (845) 451-7251

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Interoperability endpoints

  • Direct secure messaging: abradshaw@premiermedicalhv.medentdirect.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1154682250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVENUE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6966",
            "fax_number": "414-805-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVENUE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6966",
            "fax_number": "414-805-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "AZORE-DEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-05",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WI",
            "license": "101305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.