NPIMap

Individual provider Active NPI

Bradley B Anderson, MD

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1265793640
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
52638 Issued in AZ
Practice address
1111 E McDowell Rd
LL2
Phoenix, AZ 85006-2612
Phone
(602) 839-2296
Fax
(602) 839-2084
NPI assigned
Jun 1, 2012
Last updated
Dec 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 52638 AZ Primary
Internal Medicine Physician 207R00000X R73368 AZ

Addresses

Primary practice location

1111 E McDowell Rd
LL2
Phoenix, AZ 85006-2612

Mailing address

PO Box 41150
Mesa, AZ 85274-1150
Phone (480) 425-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20170505001239 AZ Practitioner - Anesthesiology 8022395797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Arizona College of Medicine, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7744 W Wescott Dr
Glendale, AZ 85308-6109
Phone (480) 540-7838

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R73368AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Spine and Joint Hospital LLC Current Accepting new patients
Camelback Anesthesia PLLC CurrentSince Apr 13, 2017 Accepting new patients
Bradley B Anderson MD PLLC Anesthesiology CurrentSince May 20, 2019 Accepting new patients

Locations

1111 E McDowell Rd
#2
Phoenix, AZ 85006
Phone (602) 839-2206

2421 E Southern Ave
Ste 7
Tempe, AZ 85282
Phone (480) 832-3600

Interoperability endpoints

  • Direct secure messaging: bradleyanderson@asjh.medalliesdirect.net

Organizations & group practices 3

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": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482883200000",
    "number": "1265793640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41150",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852741150",
            "telephone_number": "480-425-2160",
            "fax_number": "480-351-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "address_2": "LL2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-2296",
            "fax_number": "602-839-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRADLEY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-01",
        "last_updated": "2016-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "52638",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R73368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.