Active NPI
Cassandra Bradford
- Adult Health Nurse Practitioner
- Syracuse, NY
National Provider Identifier
1295233179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 308424
- Practice address
- 750 E Adams St
Syracuse, NY 13210-2306 - Phone
- (315) 464-2500
- NPI assigned
- Jan 25, 2018
- Last updated
- Jan 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 308424 | NY | Primary |
Addresses
Primary practice location
750 E Adams St
Syracuse, NY 13210-2306
Mailing address
8049 Candela Lane
Clay, NY 13041
Phone (315) 876-6740
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 25, 2025 through Mar 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 308424 | NY | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suny Health Science Center at Syracuse | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Syracuse, NY
- NPI 1578554630
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548892800000",
"number": "1295233179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8049 CANDELA LANE",
"city": "CLAY",
"state": "NY",
"postal_code": "13041",
"telephone_number": "315-876-6740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 E ADAMS ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132102306",
"telephone_number": "315-464-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "CASSANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-25",
"last_updated": "2019-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "308424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.