Active NPI
Jason Bradt, M.D.
- Emergency Medicine Physician
- Deerfield, IL
National Provider Identifier
1407147671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- K5461
- Practice address
- 1 Baxter Pkwy
Deerfield, IL 60015-4625 - Phone
- (847) 270-3772
- NPI assigned
- Apr 22, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | K5461 | TX | Primary |
Addresses
Primary practice location
1 Baxter Pkwy
Deerfield, IL 60015-4625
Mailing address
1 Baxter Pkwy
Deerfield, IL 60015-4625
Phone (847) 270-3772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K5461 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baxter Supply Services LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Durable Medical Equipment & Medical Supplies
- Deerfield, IL
- NPI 1962452243
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307491200000",
"number": "1407147671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BAXTER PKWY",
"city": "DEERFIELD",
"state": "IL",
"postal_code": "600154625",
"telephone_number": "847-270-3772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BAXTER PKWY",
"city": "DEERFIELD",
"state": "IL",
"postal_code": "600154625",
"telephone_number": "847-270-3772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADT",
"first_name": "JASON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-22",
"last_updated": "2011-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "K5461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.