Individual provider Active NPI

Bradley J McKernan, PA

  • Medical Physician Assistant
  • Buffalo, NY
National Provider Identifier
1467868281
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
85 High St
Buffalo, NY 14203-1149
Phone
(716) 630-1000
Fax
(716) 630-1348
NPI assigned
Jul 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017595 NY
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

85 High St
Buffalo, NY 14203-1149

Mailing address

425 Essjay Rd Ste 170
Williamsville, NY 14221-8235
Phone (716) 630-1219

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address production@direct.buffalomedicalgroup.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20141028001726 NY Practitioner - Physician Assistant 8022239482 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital of BuffaloGroup PAC ID 8729991666, 198 clinicians

Practice addresses (Care Compare)

2157 Main St
Buffalo, NY 14214-2648
Phone (716) 862-1000

4949 Harlem Rd
Amherst, NY 14226-2500
Phone (716) 601-3690

565 Abbott Rd
Buffalo, NY 14220-2039
Phone (716) 826-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital of Buffalo Physician Assistant CurrentSince Dec 5, 2015 Accepting new patients
Mount St. Mary'S Hospital of Niagara Falls Physician Assistant CurrentSince Nov 1, 2020 Accepting new patients
Mercy Hospital of Buffalo CurrentSince Dec 5, 2015 Accepting new patients
Kenmore Mercy Hospital CurrentSince Nov 1, 2020 Accepting new patients
Mount St. Mary'S Hospital of Niagara Falls CurrentSince Nov 1, 2020 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Sep 1, 2014 Accepting new patients
Buffalo Medical Group, P.C. CurrentSince Sep 1, 2014 Accepting new patients
Eastern Great Lakes Pathology PC Current Accepting new patients
Sisters of Charity Hospital of Buffalo, New York CurrentSince Oct 11, 2014 Accepting new patients
Sisters of Charity Hospital of Buffalo New York CurrentSince Oct 11, 2014 Accepting new patients
Sisters of Charity Hospital of Buffalo New York Past Accepting new patients
Mercy Hospital of Buffalo Past Accepting new patients

Locations

85 High St
Buffalo, NY 14203
Phone (716) 857-8623

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

144 Genesee St
Fl 3
Buffalo, NY 14203
Phone (716) 601-3690

2157 Main St
#H
Buffalo, NY 14214
Phone (716) 862-1501

565 Abbott Rd
Buffalo, NY 14220
Phone (716) 826-7000

908 Niagara Falls Blvd
Ste 208
North Tonawanda, NY 14120
Phone (716) 649-1613

5300 Military Rd
Stela Niagara, NY 14092
Phone (716) 297-4800

2950 Elmwood Ave
Tonawanda, NY 14217
Phone (716) 447-6100

425 Essjay Rd
Ste 170
Williamsville, NY 14221
Phone (716) 630-1219

6255 Sheridan Dr
Ste 304
Williamsville, NY 14221
Phone (716) 857-8666

Interoperability endpoints

  • Direct secure messaging: production@direct.buffalomedicalgroup.com

Organizations & group practices 13

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.

View all 13

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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1467868281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031149",
            "telephone_number": "716-630-1000",
            "fax_number": "716-630-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKERNAN",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017595",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "production@direct.buffalomedicalgroup.com",
            "affiliation": "N",
            "address_1": "85 High St",
            "city": "Buffalo",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142031149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.