Individual provider Active NPI

Bradley P Johnson, CRNA

  • Certified Registered Nurse Anesthetist
  • Geneva, NY
National Provider Identifier
1568427045
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
532646 Issued in NY
Practice address
196 North Street
Geneva, NY 14456
Phone
(315) 787-4533
NPI assigned
Apr 19, 2006
Last updated
Jan 11, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 532646 NY Primary

Addresses

Primary practice location

196 North Street
Geneva, NY 14456

Mailing address

202 Taughannock Blvd.
PO Box 366
Ithaca, NY 14851
Phone (607) 277-3257

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051026000656 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072530377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Albany Medical College of Union University, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geneva General Hospital, IncGroup PAC ID 7810809407, 88 clinicians

Practice addresses (Care Compare)

196 N St
Geneva, NY 14456-1651
Phone (315) 787-5355

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Geneva General Hospital, Inc CurrentSince Aug 16, 2005 Accepting new patients
Geneva General Hospital, Inc Current Accepting new patients
Geneva General Hospital Inc CurrentSince Aug 16, 2005 Accepting new patients
Jefferson Anesthesiologist Services PC Past Accepting new patients

Locations

196 North St
Geneva, NY 14456
Phone (315) 787-4156

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1568427045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 TAUGHANNOCK BLVD.",
            "address_2": "PO BOX 366",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14851",
            "telephone_number": "607-277-3257",
            "fax_number": "607-277-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 NORTH STREET",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "14456",
            "telephone_number": "315-787-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRADLEY",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "532646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.