NPIMap

Individual provider Active NPI

Bradley J Martin, P.A.-C

  • Physician Assistant
  • Loveland, CO
National Provider Identifier
1255748034
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0004502 Issued in CO
Practice address
2695 Rocky Mountain Ave
Suite 200
Loveland, CO 80538-8702
Phone
(970) 667-7664
Fax
(970) 622-9843
NPI assigned
Jul 14, 2014
Last updated
Jan 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.0004502 CO Primary

Addresses

Primary practice location

2695 Rocky Mountain Ave
Suite 200
Loveland, CO 80538-8702

Mailing address

2695 Rocky Mountain Ave
Suite 200
Loveland, CO 80538-8702
Phone (970) 667-7664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160115000789 CO Practitioner - Physician Assistant 1951623610 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Dec 23, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Feb 1, 2016 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Dec 23, 2024 Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

2315 E Harmony Rd
Ste 110
Fort Collins, CO 80528
Phone (970) 212-7600

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

750 Wellington Ave
Ste 3C
Grand Junction, CO 81501
Phone (970) 243-7908

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

2695 Rocky Mountain Ave
Ste 200
Loveland, CO 80538
Phone (970) 495-8490

Organizations & group practices 7

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1255748034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "SUITE 200",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388702",
            "telephone_number": "970-667-7664",
            "fax_number": "970-622-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "SUITE 200",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388702",
            "telephone_number": "970-667-7664",
            "fax_number": "970-622-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, CO

Sources for this page

Verify at the official NPI Registry.