Individual provider Active NPI

Mikaela K Bradley, PA-C

  • Physician Assistant
  • Livingston, NJ
National Provider Identifier
1417677758
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00723200 Issued in NJ
Practice address
200 S Orange Ave Ste 230
Livingston, NJ 07039-5817
Phone
(973) 322-7005
NPI assigned
Aug 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00723200 NJ Primary

Addresses

Primary practice location

200 S Orange Ave Ste 230
Livingston, NJ 07039-5817

Mailing address

200 S Orange Ave Ste 230
Livingston, NJ 07039-5817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221130000124 NJ Practitioner - Physician Assistant 4183092802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

100 Town Square PL
Jersey City, NJ 07310-2778

200 S Orange Ave
Livingston, NJ 07039-5817

377 Jersey Ave
Suite 280a
Jersey City, NJ 07302-4393
Phone (201) 716-5850

433 Hackensack Ave
Hackensack, NJ 07601-6319
Phone (201) 716-5850

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076
  • Jersey City Medical Center Hospital, Jersey City, NJ, CCN 310074

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00723200NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Sep 12, 2022 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Sep 12, 2022 Accepting new patients

Locations

1 Clara Maass Dr
Ste 275
Belleville, NJ 07109

433 Hackensack Ave
Fl 2
Hackensack, NJ 07601
Phone (201) 343-1717

377 Jersey Ave
Ste 550
Jersey City, NJ 07302
Phone (201) 716-5850

100 Town Square Pl
Ste 208
Jersey City, NJ 07310
Phone (201) 716-5850

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

200 S Orange Ave
Ste 230
Livingston, NJ 07039
Phone (973) 322-7005

225 Millburn Ave
Ste 104B
Millburn, NJ 07041
Phone (973) 379-5888

235 Millburn Ave
Ste 101
Millburn, NJ 07041
Phone (973) 376-8034

130 Kinderkamack Rd
Ste 300
River Edge, NJ 07661
Phone (201) 489-2727

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

Interoperability endpoints

  • Direct secure messaging: mbradley138310@epicdirect.rwjbh.org

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 3

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": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1417677758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE STE 230",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE STE 230",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817",
            "telephone_number": "973-322-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "MIKAELA",
        "middle_name": "K",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00723200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.