Bradford Blakeman, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

036060663 Issued in IL

Practice address

2650 Warrenville Rd Ste 280
Downers Grove, IL 60515-2075

Phone

(630) 324-7900

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 6

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, MI, WI3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bblakeman741990@direct.franciscanalliance.org
• Direct secure messaging: bladford.blakeman@mghvi.directbygreenway.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.

• Agnesian Healthcare, Inc

  • General Acute Care Hospital
  • Fond Du Lac, WI
  • NPI 1346228541
  Medicare reassignment NPD
• DLP Marquette Physician Practices Inc

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995

  Surgery

  Medicare reassignment NPD
• Cardiac Surgery Associates SC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Downers Grove, IL
  • NPI 1043269160
  Medicare reassignment
• Agnesian Healthcare Inc

  • Community/Retail Pharmacy
  • Waupun, WI
  • NPI 1366417917
  NPD
• Agnesian Healthcare Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fond Du Lac, WI
  • NPI 1841320884
  NPD
• DLP Marquette Physician Practices Inc

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD
• Loyola University Physician Foundation

  • General Practice Physician
  • Maywood, IL
  • NPI 1235148891
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1447212113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 WARRENVILLE RD",
            "address_2": "STE 280",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60515",
            "telephone_number": "630-324-7915",
            "fax_number": "630-271-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 WARRENVILLE RD STE 280",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152075",
            "telephone_number": "630-324-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2560 24th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Rock Island",
            "state": "IL",
            "postal_code": "612015390",
            "country_code": "US",
            "telephone_number": "309-779-3111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1414 W Fair Ave Ste 36",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498552675",
            "country_code": "US",
            "telephone_number": "906-225-3870",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1414 W Fair Ave Ste 342",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498555407",
            "country_code": "US",
            "telephone_number": "906-449-3440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 W Baraga Ave Ste 20",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498554550",
            "country_code": "US",
            "telephone_number": "906-449-3440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 MacArthur Blvd",
            "address_2": "Ste 204",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "46321",
            "country_code": "US",
            "telephone_number": "219-836-4220",
            "fax_number": "219-836-4171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1703 W Stones Crossing Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461438558",
            "country_code": "US",
            "telephone_number": "317-528-6772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8051 S Emerson Ave Ste 3658",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462378600",
            "country_code": "US",
            "telephone_number": "317-851-2331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 St Francis Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054940",
            "country_code": "US",
            "telephone_number": "765-775-2800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 S Creasy Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054972",
            "country_code": "US",
            "telephone_number": "765-502-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 S Creasy Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054972",
            "country_code": "US",
            "telephone_number": "765-502-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKEMAN",
        "first_name": "BRADFORD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "1048021",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036060663",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "1048021",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036060663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "URBANA",
            "identifier": "L92675",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKFORD",
            "identifier": "L92675",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COOK GROUP",
            "identifier": "S26620",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINE",
            "identifier": "L92675",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DUPAGE GROUP",
            "identifier": "344390",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36060663",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bblakeman741990@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 S Creasy Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479054972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ryan Billich, PT
• Emma Birch
• Casey Birkel, D.V.M
• April L Bitner, PHARMD
• Kate Blackburn
• Courtney M. Blakemore
• Robin Brent Blakkolb, D.D.S.
• Heather Blanck
• Thomas Edward Blaney, DPM
• Joan M Blasingame, SLP

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.