Active NPI
Bradley James Petek, MD
- Cardiovascular Disease Physician
- Portland, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- MD214252
- Practice address
- 3303 S Bond Ave
Portland, OR 97239-4501 - Phone
- (503) 494-1775
- Fax
- (503) 494-4749
- NPI assigned
- Jun 19, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 272368 | MA | |
| Internal Medicine Physician | 207R00000X | MD214252 | OR | |
| Cardiovascular Disease Physician | 207RC0000X | MD214252 | OR | Primary |
Addresses
Primary practice location
3303 S Bond Ave
Portland, OR 97239-4501
Mailing address
3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-1775
Other practice location 1
Massachusetts General Hospital
55 Fruit St.
Boston, MA 02114
Phone (617) 643-0596
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- University of Washington School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15700 SW Greystone CT
Beaverton, OR 97006-6011
Phone (503) 494-3442
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8311
3303 S Bond Ave
Portland, OR 97239-4501
Phone (503) 494-8311
Hospital & facility affiliations
- Ohsu Hospital and Clinics
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.11 of 100
- Quality
- 84.29
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD214252 | OR | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Past | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
3303 S Bond Ave
Portland, OR 97239
Phone (503) 494-3151
Interoperability endpoints
- bpetek163508@direct.ohsu.edu
Organizations & group practices 3
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.
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
- Multi-Specialty Clinic/Center
- Portland, OR
- NPI 1073767588
-
- Pediatrics Physician
- Medford, OR
- NPI 1225282122
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691971200000",
"number": "1558891705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3303 S BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394501",
"telephone_number": "503-494-1775",
"fax_number": "503-494-4749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3303 S BOND AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394501",
"telephone_number": "503-494-1775",
"fax_number": "503-494-4749"
}
],
"practiceLocations": [
{
"address_1": "Massachusetts General Hospital",
"address_2": "55 Fruit St.",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "02114",
"country_code": "US",
"telephone_number": "617-643-0596",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETEK",
"first_name": "BRADLEY",
"middle_name": "JAMES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-19",
"last_updated": "2023-08-14",
"certification_date": "2023-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "272368",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD214252",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "OR",
"license": "MD214252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.