Active NPI
Adam Bruderick, DO
- Diagnostic Radiology Physician
- Walnut Creek, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 25314
- Practice address
- 2401 Shadelands Dr
Walnut Creek, CA 94598-2494 - Phone
- (425) 563-1500
- NPI assigned
- Jun 16, 2021
- Last updated
- May 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 25314 | CA | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 5151015321 | MI |
Addresses
Primary practice location
2401 Shadelands Dr
Walnut Creek, CA 94598-2494
Mailing address
44405 Woodward Ave # H23
Pontiac, MI 48341-5023
Other practice location 1
44405 Woodward Ave # H23
Pontiac, MI 48341-5023
Phone (248) 858-6273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, WA, MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Campbell Univ School of Osteopathic Medicine, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Zotec Way
Carmel, IN 46032-0052
19020 33Rd Ave W
Suite 210
Lynnwood, WA 98036-4748
2001 The Embarcadero
Suite 1500
San Francisco, CA 94143-5200
490 Illinois St
San Francisco, CA 94143-2510
PO Box
Suite 5299
Tacoma, WA 98415
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25314 | CA | MD | Speech-Language Pathologist |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Josefina Narvaez Mental Health Center MH Aoa
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San Jose, CA
- NPI 1699885079
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1477624104
-
dba UCSF Pediatrics Group
- Pediatrics Physician
- San Francisco, CA
- NPI 1861578973
-
- General Acute Care Hospital
- Yakima, WA
- NPI 1306933940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1225606106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE # H23",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 SHADELANDS DR",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982494",
"telephone_number": "425-563-1500"
}
],
"practiceLocations": [
{
"address_1": "44405 Woodward Ave # H23",
"address_purpose": "LOCATION",
"city": "Pontiac",
"state": "MI",
"postal_code": "483415023",
"country_code": "US",
"telephone_number": "248-858-6273",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRUDERICK",
"first_name": "ADAM",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-16",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "25314",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "5151015321",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.