NPIMap

Individual provider Active NPI

Bradford Thomas Black, MD

  • Urology Physician
  • Alliance, OH
National Provider Identifier
1356326136
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
58282 Issued in OH
Practice address
885 S Sawburg Rd
Suite 105
Alliance, OH 44601-5905
Phone
(330) 823-1112
Fax
(330) 823-1139
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 58282 OH Primary

Addresses

Primary practice location

885 S Sawburg Rd
Suite 105
Alliance, OH 44601-5905

Mailing address

2777 Carrington St NW
North Canton, OH 44720-8163
Phone (330) 244-0515

Other identifiers 2

IdentifierTypeStateIssuer
0738536MedicaidOH
340012867OtherOHMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100721000437 OH Practitioner - Urology 7315984317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Arkansas College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Clinic 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Canton, OH, CCN 360070
  • Alliance Community Hospital Hospital, Alliance, OH, CCN 360131
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Salem Regional Medical Center Hospital, Salem, OH, CCN 360185

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58282OHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Mar 1, 2022 Accepting new patients

Locations

885 S Sawburg Ave
Ste 105
Alliance, OH 44601
Phone (330) 823-1112

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

2360 Southeast Blvd
Salem, OH 44460
Phone (330) 337-1134

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1356326136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 CARRINGTON ST NW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447208163",
            "telephone_number": "330-244-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 S SAWBURG RD",
            "address_2": "SUITE 105",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446015905",
            "telephone_number": "330-823-1112",
            "fax_number": "330-823-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BRADFORD",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OH",
            "license": "58282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0738536",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "340012867",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

Verify at the official NPI Registry.