Individual provider Active NPI

Bruce Edward Bradley, MBCHB

  • Cardiovascular Disease Physician
  • Lexington, KY
National Provider Identifier
1376850099
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
45827 Issued in KY
Practice address
100 N Eagle Creek Dr
Lexington, KY 40509
Phone
(859) 258-5300
Fax
(859) 258-5357
NPI assigned
Sep 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 45827 KY
Hospitalist Physician 208M00000X 45827 KY
Cardiovascular Disease Physician 207RC0000X 45827 KY Primary

Addresses

Primary practice location

100 N Eagle Creek Dr
Lexington, KY 40509

Mailing address

100 N Eagle Creek Dr
Lexington, KY 40509-1805
Phone (859) 258-5300

Other practice location 1

Uk Div Of Hospital Medicine
800 Rose Street, MN604
Lexington, KY 40536-0294
Phone (859) 323-6047

Other practice location 2

Uk Div Of Hospital Medicine
800 Rose Street, MN604
Lexington, KY 40536-0294
Phone (859) 323-6047

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190718003618 KY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3577704949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Lexington Clinic PSCGroup PAC ID 3476457532, 329 clinicians

Practice addresses (Care Compare)

100 N Eagle Creek Dr
Lexington, KY 40509-1805
Phone (859) 258-4000

Hospital & facility affiliations

  • Saint Joseph Hospital Hospital, Lexington, KY, CCN 180010
  • Saint Joseph Mount Sterling Hospital, Mount Sterling, KY, CCN 180064
  • Clark Regional Medical Center Hospital, Winchester, KY, CCN 180092
  • Saint Joseph London Hospital, London, KY, CCN 180011
  • Saint Joseph East Hospital, Lexington, KY, CCN 180143

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45827KYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Lexington Clinic, PSC Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
New Lexington Clinic PSC CurrentSince Aug 1, 2019 Accepting new patients

Locations

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

100 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 258-5300

Interoperability endpoints

  • Direct secure messaging: bruce.bradley.1@13059.direct.athenahealth.com

Organizations & group practices 2

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 7

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1376850099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091805",
            "telephone_number": "859-258-5300",
            "fax_number": "859-258-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40509",
            "telephone_number": "859-258-5300",
            "fax_number": "859-258-5357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Uk Div Of Hospital Medicine",
            "address_2": "800 Rose Street, MN604",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360294",
            "country_code": "US",
            "telephone_number": "859-323-6047",
            "fax_number": "859-257-3873",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Uk Div Of Hospital Medicine",
            "address_2": "800 Rose Street, MN604",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405360294",
            "country_code": "US",
            "telephone_number": "859-323-6047",
            "fax_number": "859-257-3873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "BRUCE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MBCHB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-01",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "45827",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KY",
            "license": "45827",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "45827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.