Bradley R Kozub, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA4032 Issued in MA

Practice address

55 Lake Ave N
Worcester, MA 01655-0002

Phone

(508) 334-3850

NPI assigned

Oct 19, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373
  Medicare reassignment Care Compare group
• Milford Regional Physician Group, Inc.

  • Internal Medicine Physician
  • Milford, MA
  • NPI 1902856024
  Medicare reassignment NPD
• Milford Regional Physician Group, Inc.

  • Sports Medicine (Family Medicine) Physician
  • Medway, MA
  • NPI 1508681321
  NPD

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

• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1295045680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Prospect St",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "017573003",
            "country_code": "US",
            "telephone_number": "508-473-1190",
            "fax_number": "508-482-5416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZUB",
        "first_name": "BRADLEY",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110164718A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aidis S. Kozica, D.D.S.
• Susan L Kozicz, NP
• Margaret J Koziel, MD
• Hanna Rae Kozlowski
• Hannah Kozlowski, RD
• Helen Kpalaga Kpakolo, RN
• Pulcherie Justine Kpangon
• Pauline Patience Kpannah
• Kathleen Kraas
• Katherine M. Krafsig, NP

• Physician Assistant in Worcester, MA
• Providers in Worcester, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.