Jacob R Bradshaw, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

56055 Issued in AZ

Practice address

2000 E Southern Ave Ste 102
Tempe, AZ 85282-7510

Phone

(480) 820-9141

NPI assigned

Apr 18, 2014

Sex

Male

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 AZ

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

Specialty

Anesthesiology

Education

Ohio State University College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Hospital Based Physicians Arizona LLCGroup PAC ID 3274782487, 636 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Banner Hospital Based Physicians Arizona LLC

  • Multi-Specialty Clinic/Center
  • San Tan Valley, AZ
  • NPI 1275889891
  Medicare reassignment Care Compare group NPD
• Anesthesia Partners of Arizona LLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1619452901

  AZ

  Medicare reassignment NPD
• Metro Anesthesia Consultants P C

  • Anesthesiology Physician
  • Phoenix, AZ
  • NPI 1003947391
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1447670385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E SOUTHERN AVE STE 102",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827510",
            "telephone_number": "480-820-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E SOUTHERN AVE STE 102",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827510",
            "telephone_number": "480-820-9141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_2": "Loma Linda University Medical Center-Anesthesiology",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "JACOB",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-18",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "56055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley B Anderson MD PLLC
• Cintara S. Bradley, N.D.
• Jennifer Kay Bradley, PSY.D.
• William Lowell Bradley, M.S.W.
• Christopher Michael Bradshaw, PA
• Eric Braha, LMT
• Mary Elizabeth Braham, ANPC
• Taylor Cunha Branaghan
• Ashton Phillip Branca
• Katie Branch, NMD

• Anesthesiology Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.