Individual provider Active NPI

Colin R. Bridgeman, MD

  • Pediatrics Physician
  • Lancaster, PA
National Provider Identifier
1417070673
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD437323 Issued in PA
Practice address
555 N. Duke Street
Lancaster, PA 17602-2250
Phone
(717) 544-5511
Fax
(717) 544-5333
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT188521 PA
Pediatrics Physician 208000000X MD437323 PA Primary

Addresses

Primary practice location

555 N. Duke Street
Lancaster, PA 17602-2250

Mailing address

100 E Penn SQ FL 9
Philadelphia, PA 19107-3377
Phone (267) 425-9234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20090909000215 PA Practitioner - Pediatric Medicine 5092860486 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT188521PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Associates, Inc Pediatrics Current Accepting new patients
Childrens Health Care Associates, Inc CurrentSince Aug 1, 2015 Accepting new patients
The Milton S Hershey Medical Center Physician Group CurrentSince Sep 1, 2012 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Current Accepting new patients
The Milton S Hershey Medical Center Physicians Group Pediatrics CurrentSince Sep 1, 2012 Accepting new patients
Childen'S Health Care Associates Inc. CurrentSince Aug 1, 2015 Accepting new patients
The Milton S Hershey Medical Center Past Accepting new patients
SCHC Pediatric Associates, LLC Pediatrics Past Accepting new patients
The Nemours Foundation Past Accepting new patients

Locations

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

3401 Civic Center Blvd
Philadelphia, PA 19104
Phone (215) 590-4040

Organizations & group practices 9

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1417070673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ FL 9",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073377",
            "telephone_number": "267-425-9234",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N. DUKE STREET",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022250",
            "telephone_number": "717-544-5511",
            "fax_number": "717-544-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGEMAN",
        "first_name": "COLIN",
        "middle_name": "R.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT188521",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD437323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.