Bradley S Kurgis D O Inc

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

BRADLEY S KURGIS D O INC

Practice address

1320 Las Tablas Rd
Suite B
Templeton, CA 93465-9711

Phone

(805) 434-5563

Fax

(805) 434-5916

NPI assigned

Jun 8, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Bradley S Kurgis, DONPI 1770529620

Title

Owner

Phone

(805) 434-5563

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley S Kurgis, DO

  • MOHS-Micrographic Surgery Physician
  • Templeton, CA
  • NPI 1770529620

  CA, Mohs-Micrographic Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Carianne Nicole Crowe, PA-C

  • Medical Physician Assistant
  • Templeton, CA
  • NPI 1063819829

  CA

  Medicare reassignment Care Compare group
• Daniel Perry, PA-C

  • Surgical Physician Assistant
  • Arroyo Grande, CA
  • NPI 1710352083
  NPD (past)

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1366736290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 LAS TABLAS RD",
            "address_2": "SUITE B",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659711",
            "telephone_number": "805-434-5563",
            "fax_number": "805-434-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LAS TABLAS RD",
            "address_2": "SUITE B",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659711",
            "telephone_number": "805-434-5563",
            "fax_number": "805-434-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY S KURGIS D O INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-08",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "KURGIS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-434-5563",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "20A55170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina Jo Bolduc, LM, CPM
• David Alfonso Bolivar, MD
• Martha Dandridge Bordonaro, D.C.
• Erin Jones Bouquin, MD
• Tracy L Boyan, RDHAP
• Hendrik F Breytenbach, M.D.
• Michael William Brinkman, DPT
• Jeffry Allen Brown, M.D.
• Cindy S. Buchanan, P.A.
• Roman Platon Bukachevsky, M.D.

• All providers in Templeton, CA
• MOHS-Micrographic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.