Individual provider Active NPI

Bradley Moler, PT, DPT

  • Physical Therapist
  • Belmont, NC
National Provider Identifier
1376208165
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P20796 Issued in NC
Practice address
275 Beatty Dr
Belmont, NC 28012-2715
Phone
(704) 822-2550
NPI assigned
Nov 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X P20796 NC Primary

Addresses

Primary practice location

275 Beatty Dr
Belmont, NC 28012-2715

Mailing address

1311 Mamaroneck Ave Ste 140
White Plains, NY 10605-5224

Other practice location 1

1129 E Marion St
Shelby, NC 28150-4843
Phone (704) 471-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, DE, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20211130000036 SC Practitioner - Physical Therapist in Private Practice 1850781204 Reassigns benefits to 1 organization
I20221228002619 DE Practitioner - Physical Therapist in Private Practice 1850781204 Reassigns benefits to 1 organization
I20231128002939 NC Practitioner - Physical Therapist in Private Practice 1850781204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Nova Southeastern College of Osteo Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivyrehab North Carolina LLCGroup PAC ID 8820336324, 158 clinicians

Practice addresses (Care Compare)

1129 E Marion St
Shelby, NC 28150-4843
Phone (704) 471-0001

Merit-based Incentive Payment System (MIPS)

Final score
85.3 of 100Reported as group
Quality
88.48
Improvement activities
40
Cost
72.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P20796NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Sep 2, 2022 Accepting new patients
Greenville Proaxis Therapy, LLC Physical Therapist CurrentSince Nov 1, 2021 Accepting new patients
Ivyrehab North Carolina LLC Physical Therapist CurrentSince Nov 16, 2023 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Sep 2, 2022 Accepting new patients
Greenville Proaxis Therapy LLC CurrentSince Nov 1, 2021 Accepting new patients
Ivyrehab North Carolina LLC CurrentSince Nov 16, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33205 Collection Ctr Dr
Chicago, IL 60693

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

9216 Ardrey Kell Rd
Ste 300
Charlotte, NC 28277
Phone (980) 556-7330

5960 Fairview Rd
Ste 250
Charlotte, NC 28210
Phone (980) 224-7958

836 E King St
Kings Mountain, NC 28086
Phone (704) 739-5995

1129 E Marion St
Shelby, NC 28150
Phone (704) 471-0001

1311 Mamaroneck Ave
Ste 140
White Plains, NY 10605
Phone (914) 265-4838

103 N Main St
Ste 201
Greenville, SC 29601
Phone (864) 528-5753

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1636070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1376208165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BEATTY DR",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280122715",
            "telephone_number": "704-822-2550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 E Marion St",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281504843",
            "country_code": "US",
            "telephone_number": "704-471-0001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLER",
        "first_name": "BRADLEY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-05",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.