Active NPI
Bradley Charles Robertson, M.D.
- Plastic and Reconstructive Surgery Physician
- Bel Air, MD
National Provider Identifier
1336151109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- D0037409
- Practice address
- 1 Barrington PL
Bel Air, MD 21014-5607 - Phone
- (410) 836-7205
- Fax
- (410) 836-7235
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Plastic and Reconstructive Surgery Physician | 2086S0122X | D0037409 | MD | Primary |
Addresses
Primary practice location
1 Barrington PL
Bel Air, MD 21014-5607
Mailing address
1 Barrington PL
Bel Air, MD 21014-5607
Phone (410) 836-7205
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52997412 | Other | MD | CAREFIRST |
| 45663365 | Other | MD | AETNA |
| K058 0001 | Other | DC | CAREFIRST |
| 2432226 | Other | MD | CIGNA |
| 1056903 | Other | MD | UNITED HEALTHCARE |
| 3115795 | Other | MD | OPTIMUM CHOICE |
| 099N997F | Other | MD | MEDICARE |
| P00185846 | Other | GA | RAILROAD MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0037409 | MD | MD | Plastic and Reconstructive Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363219200000",
"number": "1336151109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BARRINGTON PL",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210145607",
"telephone_number": "410-836-7205",
"fax_number": "410-836-7235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BARRINGTON PL",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210145607",
"telephone_number": "410-836-7205",
"fax_number": "410-836-7235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "BRADLEY",
"middle_name": "CHARLES",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2013-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "MD",
"license": "D0037409",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "52997412",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "45663365",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "K058 0001",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2432226",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1056903",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMUM CHOICE",
"identifier": "3115795",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "099N997F",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00185846",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bel Air, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.