Danielle Brady

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2024027957 Issued in MO

Practice address

12255 De Paul Dr Ste 770
Bridgeton, MO 63044-2515

Phone

(314) 474-7366

NPI assigned

May 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arch Dermatology Institute, LLCGroup PAC ID 6204269889, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Arch Dermatology Institute, LLC

  • Dermatology Physician
  • Bridgeton, MO
  • NPI 1427604016
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1417704438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 W ROSE AVE",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631194615",
            "telephone_number": "573-310-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR STE 770",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442515",
            "telephone_number": "314-474-7366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2024027957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry Lynn Boyer, MSW, LCSW
• Anthony Bozich, PTA
• Stephen Paul Bozoian, DMD
• Patricia Bozzi, PT, CHT
• Melissa Bradbury, PHARMD
• Donna Marie Branca, ACSW, MSW, BCD, LCSW
• Kayla Braswell
• Brianna Raynae Bray, PHARMD
• Christine E Breakfield, RDN, LD
• Bridgeton Emergency Group LLC

• Physician Assistant in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.