NPIMap

Organization Active NPI

Bradley K Becker, PC

  • Plastic and Reconstructive Surgery Physician
  • Glendale, AZ
National Provider Identifier
1255519260
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
3803 Issued in AZ
Legal business name
BRADLEY K BECKER, PC
Practice address
18555 N 79TH Ave Ste B102
Glendale, AZ 85308-8372
Phone
(602) 610-9111
Fax
(602) 867-4247
NPI assigned
Feb 1, 2008
Last updated
May 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Authorized official

Name
Dr. Bradley K Becker, D.O.NPI 1245307396
Title
Owner
Phone
(602) 867-1302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 3803 AZ Primary

Addresses

Primary practice location

18555 N 79TH Ave Ste B102
Glendale, AZ 85308-8372

Mailing address

18555 N 79TH Ave Ste B102
Glendale, AZ 85308-8372
Phone (602) 439-1111

National Provider Directory

National Provider Directory

Locations

2222 E Highland Ave
#200
Phoenix, AZ 85016
Phone (602) 354-7600

3900 E Camelback Rd
Ste 200
Phoenix, AZ 85018
Phone (602) 354-7600

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589155200000",
    "number": "1255519260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18555 N 79TH AVE STE B102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088372",
            "telephone_number": "602-439-1111",
            "fax_number": "602-867-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18555 N 79TH AVE STE B102",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088372",
            "telephone_number": "602-610-9111",
            "fax_number": "602-867-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY K BECKER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-867-1302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AZ",
            "license": "3803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.