Stanley Kasimir Bradshaw IV, MS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

300 Pasteur Drive
Lane 154
Stanford, CA 94305-5133

Phone

(650) 723-6661

Fax

(650) 498-6205

NPI assigned

Apr 15, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brad Bradshaw Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Anesthesiology

Education

University of Texas Southwestern Medical School at Dallas, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1215518840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DRIVE",
            "address_2": "LANE 154",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055133",
            "telephone_number": "650-723-6661",
            "fax_number": "650-498-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DRIVE",
            "address_2": "LANE 154",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055133",
            "telephone_number": "650-723-6661",
            "fax_number": "650-498-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "STANLEY",
        "middle_name": "KASIMIR",
        "name_prefix": "Mr.",
        "name_suffix": "IV",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRAD",
            "last_name": "BRADSHAW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Branson Boykins
• Kliment Krassimirov Bozhilov, MD
• Alison Bozung, OD
• Thomas Cadbury Richard Bradley
• Christina Leigh Bradshaw, MD
• Brian Michael Brady, M.D.
• Vijayalakshmi Madivalappa Brahmashettar, MD
• Jason Taylor Braley, PA-C
• Michael Gregory Brandel, MD
• Gregory Lawrence Branigan, MD, PHD

• Student in an Organized Health Care Education/Training Program in Stanford, CA
• Providers in Stanford, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.