Bradley Walters, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2013-0052 Issued in NM

Practice address

610 Broadway Blvd NE
Albuquerque, NM 87102-2372

Phone

(505) 225-2500

Fax

(505) 225-2025

NPI assigned

Aug 15, 2013

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 NM, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optumcare New Mexico LLCGroup PAC ID 9032125810, 69 clinicians

Dermatology of New Mexico LLCGroup PAC ID 6608209606, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwalters191861@westdirect.optum.com

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.

• Dermatology of New Mexico LLC

  • Clinic/Center
  • Albuquerque, NM
  • NPI 1104468438
  Medicare reassignment Care Compare group NPD
• Optumcare New Mexico LLC

  • Family Medicine Physician
  • Albuquerque, NM
  • NPI 1124053210
  Medicare reassignment Care Compare group NPD
• Albuquerque Indian Health Center

  • Clinic/Center
  • Albuquerque, NM
  • NPI 1659458917

  TX

  Medicare reassignment
• Albuquerque Urgent Care Walk in Clinic PC

  • Urgent Care Clinic/Center
  • Albuquerque, NM
  • NPI 1487167961
  Medicare reassignment
• McLeod Medical Centers of NM, Inc.

  • Family Medicine Physician
  • Cedar Crest, NM
  • NPI 1700393782
  Medicare reassignment
• Oak Street Health Physicians Group of New Mexico LLC

  • Primary Care Clinic/Center
  • Albuquerque, NM
  • NPI 1134793151
  Medicare reassignment
• Presbyterian Healthcare Services

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354
  Medicare reassignment
• Rehabilitation Partners

  • Physical Medicine & Rehabilitation Physician
  • Albuquerque, NM
  • NPI 1033492673
  Medicare reassignment
• Santa Ana Health Center

  • Health Service Clinic/Center
  • Bernalillo, NM
  • NPI 1649331323

  TX

  Medicare reassignment
• McLeod Medical Centers of NM, Inc.

  • Family Medicine Physician
  • Cedar Crest, NM
  • NPI 1215580832
  NPD
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1730684853
  NPD

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1386077196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-225-2500",
            "fax_number": "505-225-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-225-2500",
            "fax_number": "505-225-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "BRADLEY",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-15",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2013-0052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58688005",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Walsh, SLP
• Peter John Walsh, MSW
• Sonya M Walsh, CNP
• Yvonne Wylie Walston, D.O.M.
• Michael John Walta, MD
• Bradley Darin Walters, D.C.
• Cassandra Walters
• Cathy A Walters, ATC, LAT, CSCS
• Eric Walters, MA
• Erika Walters, OT

• Physician Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; 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.