Individual provider Active NPI

Gwynne A Bragdon, M.D.

  • Orthopaedic Surgery Physician
  • Middletown, RI
National Provider Identifier
1164430856
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD12438 Issued in RI
Practice address
345 Valley Rd
Middletown, RI 02842-5236
Phone
(401) 380-1188
NPI assigned
Aug 4, 2006
Last updated
Feb 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Orthopaedic Surgery Physician 207X00000X MD434563 PA
Orthopaedic Surgery Physician 207X00000X MD12438 RI Primary
Orthopaedic Hand Surgery Physician 207XS0106X MD12438 RI
Orthopaedic Hand Surgery Physician 207XS0106X MD434563 PA

Addresses

Primary practice location

345 Valley Rd
Middletown, RI 02842-5236

Mailing address

PO Box 1119
Providence, RI 02901-1119
Phone (401) 443-4150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20161102003006 RI Practitioner - Orthopedic Surgery 7214003722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Drexel University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopedics IncGroup PAC ID 9931000395, 185 clinicians

Practice addresses (Care Compare)

2 Dudley St
Suite 200
Providence, RI 02905-3248
Phone (401) 457-1500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
66.76
Promoting interoperability
96
Improvement activities
40
Cost
77

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD434563PAMDOrthopaedic Surgery Physician

Interoperability endpoints

  • Direct secure messaging: gwynne.bragdon.1@13709.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1164430856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011119",
            "telephone_number": "401-443-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425236",
            "telephone_number": "401-380-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGDON",
        "first_name": "GWYNNE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "MD434563",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "RI",
            "license": "MD12438",
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "RI",
            "license": "MD12438",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "PA",
            "license": "MD434563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

Verify at the official NPI Registry.