Individual provider Active NPI

Joel Matthew Bradley, M.D.

  • Pediatrics Physician
  • Lebanon, NH
National Provider Identifier
1164782850
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
17489 Issued in NH
Practice address
1 Medical Center Dr
Dartmouth Hitchcock - Pediatrics
Lebanon, NH 03756-1000
Phone
(603) 653-6063
NPI assigned
May 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 17489 NH Primary
Internal Medicine Physician 207R00000X EC121077 ME

Addresses

Primary practice location

1 Medical Center Dr
Dartmouth Hitchcock - Pediatrics
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Dartmouth Hitchcock - Pediatrics
Lebanon, NH 03756-1000
Phone (603) 653-6063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20160819000880 NH Practitioner - Pediatric MedicinePractitioner - Internal Medicine 0648404301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Internal Medicine
Education
University of Massachusetts Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 1, 2016 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • Direct secure messaging: jbradley235151@direct.dartmouth-hitchcock.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
VNH - Visiting Nurse and Hospice for Vermont and New HampshireWhite River Junction, VT, CCN 477002 Home health agency Corporate Director Jul 1, 2023
VNH - Visiting Nurse and Hospice for Vermont and New HampshireWhite River Junction, VT, CCN 471506 Hospice Corporate Director Jul 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

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": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1164782850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DARTMOUTH HITCHCOCK - PEDIATRICS",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DARTMOUTH HITCHCOCK - PEDIATRICS",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-6063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JOEL",
        "middle_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-29",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "17489",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "EC121077",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.