Bradley W. Bakotic, DO

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

048594 Issued in GA

Practice address

2001 Westside Parkway
Suite 290
Alpharetta, GA 30004-8514

Phone

(877) 376-7284

Fax

(770) 475-0533

NPI assigned

Dec 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Osteopathy

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.

• Hub Care Pathology, P.a.

  • Anatomic Pathology & Clinical Pathology Physician
  • Hattiesburg, MS
  • NPI 1043324767
  Medicare reassignment NPD
• Bakotic Pathology Associates, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Alpharetta, GA
  • NPI 1275858524
  NPD (past)
• Bakotic Pathology Associates, LLC

  • Clinical Medical Laboratory
  • Tampa, FL
  • NPI 1629781752
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1295710754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6039",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041056039",
            "telephone_number": "888-302-3045",
            "fax_number": "207-347-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 WESTSIDE PARKWAY",
            "address_2": "SUITE 290",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048514",
            "telephone_number": "877-376-7284",
            "fax_number": "770-475-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKOTIC",
        "first_name": "BRADLEY",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "FL",
            "license": "OS8431",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "OS8431",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "GA",
            "license": "048594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262219000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Davis Baker, SLP
• Neal Baker, PHD
• Bakotic Pathology Associates, LLC
• Bakotic Pathology Associates, LLC
• Bakotic Pathology Associates, LLC
• Wayne L Bakotic, D.O.
• Surinder Kaur Bal, PHD
• Latha Balakrishnan, OT
• Balanced Life Family Counseling, LLC
• Casey Baldwin

• Dermatopathology (Pathology) Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Dermatopathology (Pathology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.