Individual provider Active NPI

Bradley Maestas

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1306356431
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2173 Issued in NM
Practice address
6751 Academy Rd NE
Albuquerque, NM 87109-3386
Phone
(505) 503-8376
NPI assigned
Oct 3, 2017
Last updated
Oct 3, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2173 NM Primary

Addresses

Primary practice location

6751 Academy Rd NE
Albuquerque, NM 87109-3386

Mailing address

9409 Bent Rd NE Ste C
Albuquerque, NM 87109-6388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2173NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speegle Chiropractic LLC Chiropractor 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.

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1306356431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9409 BENT RD NE STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6751 ACADEMY RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093386",
            "telephone_number": "505-503-8376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAESTAS",
        "first_name": "BRADLEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "2173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.