Individual provider Active NPI

Bradley J Baughman, O.D.

  • Optometrist
  • Dayton, OH
National Provider Identifier
1215934625
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T1892 Issued in OH
Practice address
8216 N Main St
Dayton, OH 45415-1641
Phone
(937) 898-2300
Fax
(937) 898-2348
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T1892 OH Primary

Addresses

Primary practice location

8216 N Main St
Dayton, OH 45415-1641

Mailing address

8216 N Main St
Dayton, OH 45415-1641
Phone (937) 898-2300

Other identifiers 3

IdentifierTypeStateIssuer
2201360OtherOHUHC
000000064638OtherOHANTHEM
2298893MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100407000681 OH Practitioner - Optometry 8527194190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyedocs Family Eye CareGroup PAC ID 8325308679, 4 clinicians

Practice addresses (Care Compare)

430 Arlington Rd
Suite a
Brookville, OH 45309-1103
Phone (937) 770-1265

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5015OHMDRegistered Dietitian
T1892OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyedocs Family Eye Care Optometrist CurrentSince Oct 23, 2023 Accepting new patients

Locations

430 Arlington Rd
Ste B
Brookville, OH 45309
Phone (937) 770-1265

430 Arlington Rd
Ste A
Brookville, OH 45309
Phone (937) 770-1265

1265 W Market St
Germantown, OH 45327
Phone (937) 770-1265

Organizations & group practices 1

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1215934625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8216 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151641",
            "telephone_number": "937-898-2300",
            "fax_number": "937-898-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8216 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151641",
            "telephone_number": "937-898-2300",
            "fax_number": "937-898-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUGHMAN",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "T1892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2201360",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000064638",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2298893",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.