Mark Stephen Bradley, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2002-0015 Issued in NM

Practice address

1925 Aspen Dr Ste 500B
Santa Fe, NM 87505-5495

Phone

(505) 466-2575

Fax

(505) 466-2575

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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

Ophthalmology

Education

University of Connecticut School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Mark S. Bradley, M.D. LLC

  • Ophthalmology Physician
  • Santa Fe, NM
  • NPI 1891929238

  NM, Ophthalmology

  Medicare reassignment NPD Authorized official
• Jerald J. Littlefield, M.D., P.C.

  • Ophthalmology Physician
  • Santa Fe, NM
  • NPI 1912038118

  Ophthalmology

  NPD (past)
• Jerald J. Littlefield, MD, PC

  • Ophthalmology Physician
  • Alexandria, VA
  • NPI 1639351174

  Ophthalmology

  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248566400000",
    "number": "1497786867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 ASPEN DR STE 500B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055495",
            "telephone_number": "505-466-2575",
            "fax_number": "505-466-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 ASPEN DR STE 500B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055495",
            "telephone_number": "505-466-2575",
            "fax_number": "505-466-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NM",
            "license": "2002-0015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85327760",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "NM400109",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Boyd
• Jan L Boyer, MA LPCC SEP
• David Bracho, D.O.
• Braden Partners LP
• Cory Bradish
• Mary E Bradshaw, LPCC
• Mary Bradtke, LMHC
• Roisin Michelle Brady
• Brain Injury Services of New Mexico, LLC
• Brain-Body-Spirit- LLC

• All providers in Santa Fe, NM
• Ophthalmology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2009; 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.