Individual provider Active NPI

Bradley Edward Talley, M.D.

  • Ophthalmology Physician
  • Jefferson City, MO
National Provider Identifier
1548471618
Registry record updated Jun 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2013006634 Issued in MO
Practice address
1705 Christy Dr
Ste. 101
Jefferson City, MO 65101-5195
Phone
(573) 635-0115
Fax
(573) 635-0116
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2013006634 MO Primary

Addresses

Primary practice location

1705 Christy Dr
Ste. 101
Jefferson City, MO 65101-5195

Mailing address

1705 Christy Dr
Ste. 101
Jefferson City, MO 65101-5195
Phone (573) 635-0115

Other identifiers 2

IdentifierTypeStateIssuer
1548471618OtherMOMEDICARE NPI
1548471618MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20130720000082 MO Practitioner - Ophthalmology 3971795980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
St. Louis College of Physicians and Surgeons, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capitol Eye Care, Inc.Group PAC ID 3072613785, 6 clinicians

Practice addresses (Care Compare)

1705 Christy Dr
Jefferson City, MO 65101-5195
Phone (573) 635-0115

Merit-based Incentive Payment System (MIPS)

Final score
93.65 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.82

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery430
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Eye Care, Inc. CurrentSince Jun 3, 2013 Accepting new patients

Locations

1705 Christy Dr
Ste 101
Jefferson Cty, MO 65101
Phone (573) 635-0115

321 W Promenade St
Mexico, MO 65265
Phone (573) 581-8811

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1548471618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CHRISTY DR",
            "address_2": "STE. 101",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015195",
            "telephone_number": "573-635-0115",
            "fax_number": "573-635-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 CHRISTY DR",
            "address_2": "STE. 101",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015195",
            "telephone_number": "573-635-0115",
            "fax_number": "573-635-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "BRADLEY",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "2013006634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1548471618",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548471618",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.