Individual provider Active NPI

David A. Bradley, O.D.

  • Optometrist
  • Yuba City, CA
National Provider Identifier
1275504391
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7747T Issued in CA
Practice address
1160 Live Oak Blvd
Yuba City, CA 95991-3407
Phone
(530) 673-8440
Fax
(530) 673-0177
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7747T CA Primary

Addresses

Primary practice location

1160 Live Oak Blvd
Yuba City, CA 95991-3407

Mailing address

1160 Live Oak Blvd
Yuba City, CA 95991-3407
Phone (530) 673-8440

Other identifiers 1

IdentifierTypeStateIssuer
SD0077470MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100908000986 CA Practitioner - Optometry 6103941513 Reassigns benefits to 1 organization
O20100930041429 CA DME Supplier - Physician - Optometrist 2062539935 Practice locations: Yuba City, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bradley Optometry IncGroup PAC ID 1557598877, 2 clinicians

Practice addresses (Care Compare)

1160 Live Oak Blvd
Yuba City, CA 95991-3407
Phone (530) 673-8440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7747TCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
RX Now Inc CurrentSince Sep 8, 2010 Accepting new patients
Bradley Optometry Inc Optometrist CurrentSince Oct 1, 2013 Accepting new patients

Locations

1160 Live Oak Blvd
Yuba City, CA 95991
Phone (530) 673-8440

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1275504391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 LIVE OAK BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959913407",
            "telephone_number": "530-673-8440",
            "fax_number": "530-673-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 LIVE OAK BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959913407",
            "telephone_number": "530-673-8440",
            "fax_number": "530-673-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "DAVID",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "7747T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0077470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.