NPIMap

Individual provider Active NPI

Kenneth Sterling Bradley, MD

  • Pain Medicine Physician
  • Torrance, CA
National Provider Identifier
1558479352
Registry record updated May 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
G82005 Issued in CA
Practice address
4201 Torrance Blvd
Suite 590
Torrance, CA 90503-4536
Phone
(310) 540-9888
Fax
(310) 540-0444
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 10347 NV
Anesthesiology Physician 207L00000X G82005 CA
Anesthesiology Physician 207L00000X 4301079245 MI
Pain Medicine Physician 208VP0000X G82005 CA Primary

Addresses

Primary practice location

4201 Torrance Blvd
Suite 590
Torrance, CA 90503-4536

Mailing address

PO Box 2129
Palos Verdes Peninsula, CA 90274-8129
Phone (310) 540-9888

Other identifiers 3

IdentifierTypeStateIssuer
100503440MedicaidNV
P00170873OtherNVRAILROAD MEDICARE
CC9142OtherNVBC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000641 CA Practitioner - Pain ManagementPractitioner - Anesthesiology 9739080557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Loma Linda University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Pain Consultants, IncGroup PAC ID 8729238662, 2 clinicians

Practice addresses (Care Compare)

4201 Torrance Blvd
Suite 590
Torrance, CA 90503-4536
Phone (310) 540-9888

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
82005CAMDPharmacist
4301079245MIMDAnesthesiology Physician
10347NVMDAnesthesiology Physician
G82005CAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SCPC Surgery Center Current Accepting new patients
Gardena Hospital LP Past Accepting new patients
Grossmont Anesthesia Services Medical Group Inc Anesthesiology Past Accepting new patients
Ahmc Whittier Hospital Medical Center LP Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Algos Inc., a Medical Corporation Pain Medicine Past Accepting new patients
Little Company of Mary Affiliated Services Inc Past Accepting new patients
Providence Health System Southern California Past Accepting new patients

Locations

4201 Torrance Blvd
Ste 590
Torrance, CA 90503
Phone (310) 540-0300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 10

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401408000000",
    "number": "1558479352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902748129",
            "telephone_number": "310-540-9888",
            "fax_number": "310-540-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 TORRANCE BLVD",
            "address_2": "SUITE 590",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034536",
            "telephone_number": "310-540-9888",
            "fax_number": "310-540-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "KENNETH",
        "middle_name": "STERLING",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NV",
            "license": "10347",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G82005",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301079245",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "G82005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503440",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00170873",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "CC9142",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.