Bradley Bomba

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1031296 Issued in TX

Practice address

2701 Hospital Dr
Victoria, TX 77901-5748

Phone

(361) 573-9181

NPI assigned

Sep 22, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Victoria Nephrology Associates LLC 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Medical Center Hospital, Victoria, TX, CCN 450023
• De Tar Hospital Navarro Hospital, Victoria, TX, CCN 450147

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Victoria Nephrology Associates LLC

  • Nephrology Physician
  • Victoria, TX
  • NPI 1023398989

  TX

  Medicare reassignment Care Compare group NPD
• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162
  NPD (past)

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

• Citizens Medical Center County of Victoria

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1124052162

  Hospital

  Care Compare affiliation
• Victoria of Texas LP

  • General Acute Care Hospital
  • Victoria, TX
  • NPI 1851343909

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675468800000",
    "number": "1356957591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR STE 114",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015748",
            "telephone_number": "361-582-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 HOSPITAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015748",
            "telephone_number": "361-573-9181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBA",
        "first_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-22",
        "last_updated": "2023-02-04",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1031296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS  BON",
            "identifier": "770765",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Bludau, NP
• Jennifer Foxell Bluntzer, DNP, APRN, ACAGNP-BC
• Paige Bode
• Angie M Bolom, OTR
• Judy Bolton, LPC
• Roel Bondoc
• Bone Health Clinic of Victoria PLLC
• Christina A Boothe, OTR
• George Theodore Boozalis, M.D.
• Stacie Linae Borchert

• All providers in Victoria, TX
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2023; 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.