Stephen Jerome Bradley, M.D.

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

4301050040 Issued in MI

Practice address

4160 John R St
Ste 615
Detroit, MI 48201-2020

Phone

(313) 745-4195

Fax

(313) 745-8669

NPI assigned

Jul 7, 2006

Last updated

Oct 17, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

• Rockford Surgical Service, S.C.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Rockford, IL
  • NPI 1073679411
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1164455028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400 - CREDENTIALING DEPARTMENT",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "313-745-4195",
            "fax_number": "313-993-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "STE 615",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-745-4195",
            "fax_number": "313-745-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "STEPHEN",
        "middle_name": "JEROME",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301050040",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MI",
            "license": "4301050040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31523400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020017324",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078462",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcas Steven Bradley Sr.
• Meredith Virginia Bradley, MD
• Mitchell R Bradley, CRNA
• Nitrice Bradley, LMT
• Patrick Bradley, MD
• Thomas Edward Bradley Jr., CPRC
• Ann Marie Brady, LMSW
• Erin J Brady, CRNA
• Kathleen Ann Brady, NP
• Kathy Denise Brady

• Surgical Critical Care Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Surgical Critical Care Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.