NPIMap

Individual provider Active NPI

Bradford Jay Stephens, M.D.

  • Specialist
  • Miami, OK
National Provider Identifier
1366444648
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
18454 Issued in OK
Practice address
202 A SW
Miami, OK 74354
Phone
(918) 541-9400
Fax
(918) 541-9411
NPI assigned
Jun 1, 2005
Reactivated
Mar 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 18454 OK Primary

Addresses

Primary practice location

202 A SW
Miami, OK 74354

Mailing address

202 A SW
Miami, OK 74354
Phone (918) 541-9400

Other identifiers 4

IdentifierTypeStateIssuer
100048810AMedicaidOK
5975535OtherOKAETNA PROVIDER NUMBER
37D1002186OtherOKCLIA WAIVE NUMBER
P00066051OtherOKRAILROD MEDICARE PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20061102000308 OK Practitioner - Internal MedicinePractitioner - General Practice 6507863677 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
University of Oklahoma College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integris Ambulatory Care Corporation 687 clinicians

Practice addresses (Care Compare)

200 2ND Ave SW
Integris Brap Hospitalists GRP
Miami, OK 74354-6830
Phone (918) 542-6611

202 A St SW
Miami, OK 74354-7604
Phone (918) 541-9400

202 A SW
Miami, OK 74354-7604

Hospital & facility affiliations

  • Integris Home Care Northeast Home health agency, Miami, OK, CCN 377050
  • Amedisys Home Health Home health agency, Grove, OK, CCN 377072
  • Integris Hospice Northeast Hospice, Miami, OK, CCN 371586
  • Good Shepherd Hospice, Inc. Hospice, Grove, OK, CCN 371574
  • Integris Miami Hospital Hospital, Miami, OK, CCN 370004
  • Integris Grove Hospital Hospital, Grove, OK, CCN 370113
  • Mercy Hospital Joplin Hospital, Joplin, MO, CCN 260001
  • Eastwood Manor Nursing home, Commerce, OK, CCN 375529
  • Windridge Nursing and Rehabilitation Center Nursing home, Miami, OK, CCN 375335

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18454OKMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Integris Ambulatory Care Corporation CurrentSince Feb 1, 2018 Accepting new patients
Bradford Jay Stephens MD PC Specialist CurrentSince Jan 9, 2007 Accepting new patients
Miami Healthcare, LLC Past Accepting new patients
Quapaw Counseling Services PastSince Jun 15, 2019 Accepting new patients
Integris Miami Hospital Past Accepting new patients
Eastwood Manor, LLC Past Accepting new patients
Palmetto Health Past Accepting new patients

Locations

310 2nd Ave SW
Ste 101
Miami, OK 74354
Phone (800) 440-4905

202 A St SW
Miami, OK 74354
Phone (918) 541-9400

200 2nd Ave SW
Miami, OK 74354
Phone (918) 540-7113

3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589

Interoperability endpoints

  • Direct secure messaging: bstephens179383@ahs.direct-ci.com
  • Direct secure messaging: bstephens67172@direct.integrisok.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Integris Hospice NortheastMiami, OK, CCN 371586 Hospice Contracted Managing Employee
Operational/Managerial Control		 Apr 9, 2012
Apr 9, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 12

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366444648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 A SW",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "74354",
            "telephone_number": "918-541-9400",
            "fax_number": "918-541-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 A SW",
            "city": "MIAMI",
            "state": "OK",
            "postal_code": "74354",
            "telephone_number": "918-541-9400",
            "fax_number": "918-541-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "BRADFORD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2023-03-07",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "18454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100048810A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "5975535",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVE NUMBER",
            "identifier": "37D1002186",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROD MEDICARE PROVIDER",
            "identifier": "P00066051",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, OK

Sources for this page

Verify at the official NPI Registry.