Bradley Smith, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-249 Issued in ME

Practice address

13 Industrial Park Rd
Saco, ME 04072-1804

Phone

(207) 283-8800

Fax

(207) 286-9853

NPI assigned

May 21, 2009

Last updated

Apr 1, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Portland Community Health CenterGroup PAC ID 5395998017, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bradley.smith.p1@direct.portlandchc.nextgenshare.com

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.

• Portland Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Portland, ME
  • NPI 1609120856
  Medicare reassignment Care Compare group
• Mainehealth

  dba MaineHealth Pharmacy Maine Medical Center Biddeford

  • General Acute Care Hospital
  • Biddeford, ME
  • NPI 1659392819
  Medicare reassignment NPD
• Mainehealth

  • Skilled Nursing Facility
  • Sanford, ME
  • NPI 1447342209
  NPD
• Portland Community Health Center

  dba Portland High School

  • Federally Qualified Health Center (FQHC)
  • Portland, ME
  • NPI 1871043810
  NPD
• Portland Community Health Center

  dba Greater Portland Health

  • Federally Qualified Health Center (FQHC)
  • Portland, ME
  • NPI 1982338240
  NPD
• Portland Community Health Center

  dba Greater Portland Health

  • Federally Qualified Health Center (FQHC)
  • Portland, ME
  • NPI 1952144842
  NPD (past)
• University of New England

  dba University Health Care

  • Physical Therapist
  • Portland, ME
  • NPI 1811974124
  NPD (past)

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1245465038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 626",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040050626",
            "telephone_number": "207-282-9080",
            "fax_number": "207-286-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 INDUSTRIAL PARK RD",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721804",
            "telephone_number": "207-283-8800",
            "fax_number": "207-286-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRADLEY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-21",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA-249",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "PA249",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245465038",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Sloan, OTR/L
• Crystal N Slone, LCSW
• Cynthia Ann Small, LCSW
• Rebecca Smart, CAC9435
• Amy L. Smith, LCSW
• Kenneth R. Smith, LCPC
• Kimberly Beatham Smith
• Melody Jean Smith, RN
• Nicole Ashley Smith, COTA
• Stephen A Sokol, MD

• Physician Assistant in Saco, ME
• Providers in Saco, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.