Individual provider Active NPI

Bradley Nathaniel Maller, MD

  • Hematology & Oncology Physician
  • Charlottesville, VA
National Provider Identifier
1205459054
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
0116034551 Issued in VA
Practice address
500 Martha Jefferson Dr Ste 315a
Charlottesville, VA 22911-4668
Phone
(434) 654-8390
Fax
(434) 654-8399
NPI assigned
May 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 0116034551 VA Primary

Addresses

Primary practice location

500 Martha Jefferson Dr Ste 315a
Charlottesville, VA 22911-4668

Mailing address

500 Martha Jefferson Dr Ste 315a
Charlottesville, VA 22911-4668
Phone (434) 654-8390

Other practice location 1

1001 E Leigh St Fl 4
Richmond, VA 23298-5004
Phone (804) 828-7999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200818000265 VA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7810313103

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of South Florida College of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

800 Independence Blvd
FL 5
Virginia Beach, VA 23455-6011

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1205459054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR STE 315A",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-654-8390",
            "fax_number": "434-654-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARTHA JEFFERSON DR STE 315A",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229114668",
            "telephone_number": "434-654-8390",
            "fax_number": "434-654-8399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 E Leigh St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985004",
            "country_code": "US",
            "telephone_number": "804-828-7999",
            "fax_number": "804-828-5941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLER",
        "first_name": "BRADLEY",
        "middle_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-27",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0116034551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.