Individual provider Active NPI

Bradley Joel Taylor

  • Optometrist
  • Fayetteville, AR
National Provider Identifier
1508360553
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3010 Issued in OK
Practice address
1100 N College Ave
Fayetteville, AR 72703
Phone
(479) 444-5093
Fax
(479) 587-6105
NPI assigned
Mar 22, 2018
Last updated
Aug 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2785 AR
Optometrist 152W00000X 3010 OK Primary

Addresses

Primary practice location

1100 N College Ave
Fayetteville, AR 72703

Mailing address

1100 N College Ave
Fayetteville, AR 72703-1944
Phone (479) 444-5093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190530002612 AR Practitioner - Optometry 9638402928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Center PAGroup PAC ID 5395713382, 8 clinicians

Practice addresses (Care Compare)

594 E Millsap Rd
Fayetteville, AR 72703-4096
Phone 4794422020107

Merit-based Incentive Payment System (MIPS)

Final score
90.36 of 100Reported as group
Quality
93.44
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2785ARMDGeneral Practice Dentistry
3010OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Center, PA Optometrist CurrentSince May 9, 2019 Accepting new patients

Locations

594 E Millsap Rd
Fayetteville, AR 72703
Phone (479) 442-2020

Interoperability endpoints

  • Direct secure messaging: btaylor@eyecenternwa.emadirect.md

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1508360553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-444-5093",
            "fax_number": "479-587-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-444-5093",
            "fax_number": "479-587-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BRADLEY",
        "middle_name": "JOEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2785",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.