Individual provider Active NPI

Adam Bruderick, DO

  • Diagnostic Radiology Physician
  • Walnut Creek, CA
National Provider Identifier
1225606106
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25314 Issued in CA
Practice address
2401 Shadelands Dr
Walnut Creek, CA 94598-2494
Phone
(425) 563-1500
NPI assigned
Jun 16, 2021
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, MI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20260529001513 CA Practitioner - Diagnostic Radiology 9638575145 Reassigns benefits to 3 organizations
I20260529002854 WA Practitioner - Diagnostic Radiology 9638575145 Reassigns benefits to 1 organization
I20260623001619 MI Practitioner - Diagnostic Radiology 9638575145

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

LicenseStateTypeSpecialty
25314CAMDSpeech-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.

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

Verify at the official NPI Registry.