Active NPI
Bradenton Surgical Group PA
- Vascular Surgery Physician
- Bradenton, FL
National Provider Identifier
1164418182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- Legal business name
- BRADENTON SURGICAL GROUP PA
- Practice address
- 200 3Rd Ave W
Ste 110
Bradenton, FL 34205-8626 - Phone
- (941) 744-2700
- Fax
- (941) 744-2705
- NPI assigned
- Sep 26, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gary M Bunch, MD
- Title
- Owner
- Phone
- (941) 744-2700
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | FL | Primary |
Addresses
Primary practice location
200 3Rd Ave W
Ste 110
Bradenton, FL 34205-8626
Mailing address
200 3Rd Ave W
Suite 110
Bradenton, FL 34205-8626
Phone (941) 744-2700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CK2566 | Other | FL | RAIL ROAD MEDICARE |
| 7385373 | Other | FL | AETNA |
| 94850 | Other | FL | BCBS |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Bradenton, FL
- NPI 1730174442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1164418182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 3RD AVE W",
"address_2": "SUITE 110",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342058626",
"telephone_number": "941-744-2700",
"fax_number": "941-744-2705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 3RD AVE W",
"address_2": "STE 110",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342058626",
"telephone_number": "941-744-2700",
"fax_number": "941-744-2705"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRADENTON SURGICAL GROUP PA",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-26",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "BUNCH",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "941-744-2700",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "CK2566",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7385373",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "94850",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.