Individual provider Active NPI

Bradley J. Ferrara, MD

  • Physical Medicine & Rehabilitation Physician
  • Willow Grove, PA
National Provider Identifier
1205883139
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD067744L Issued in PA
Practice address
2325 Maryland Road Suite 200
Willow Grove, PA 19090
Phone
(215) 657-9393
Fax
(215) 657-9398
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD067744L PA Primary

Addresses

Primary practice location

2325 Maryland Road Suite 200
Willow Grove, PA 19090

Mailing address

2325 Maryland Rd Ste 200
Willow Grove, PA 19090-1760
Phone (215) 657-9393

Other identifiers 4

IdentifierTypeStateIssuer
0872975000OtherPAAMERIHEALTH
7127234OtherPAAETNA
1231975OtherPACIGNA
FR950467OtherPAHIGHMARK BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070417000656 PA Practitioner - Physical Medicine and Rehabilitation 3870698004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD067744LPAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Philadelphia Pain Management Center Physical Medicine & Rehabilitation Past Accepting new patients
Excelsia Physicians Group LLC PastSince May 1, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1205883139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 MARYLAND RD STE 200",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "190901760",
            "telephone_number": "215-657-9393",
            "fax_number": "215-657-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 MARYLAND ROAD SUITE 200",
            "city": "WILLOW GROVE",
            "state": "PA",
            "postal_code": "19090",
            "telephone_number": "215-657-9393",
            "fax_number": "215-657-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRARA",
        "first_name": "BRADLEY",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD067744L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0872975000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7127234",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1231975",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "FR950467",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow Grove, PA

Sources for this page

Verify at the official NPI Registry.