Mary Ellen Brademas, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

155268 Issued in NY

Practice address

11 5TH Ave
Ste F
New York, NY 10003

Phone

(212) 477-7515

Fax

(212) 477-4826

NPI assigned

Sep 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: mbrademas673145@nychhc.direct-ci.com

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1568565976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 5TH AVE",
            "address_2": "STE F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-477-7515",
            "fax_number": "212-477-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 5TH AVE",
            "address_2": "STE F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10003",
            "telephone_number": "212-477-7515",
            "fax_number": "212-477-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADEMAS",
        "first_name": "MARY ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "155268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mazdak Moghaddam Bradberry, MD, PHD
• Niyah Alise Bradberry
• Michelle S Bradbury, MD, PHD
• Mary Elizabeth Braddock, PH.D.
• Tanaeja Braddox
• Braden Josephson Psychological Services
• Braden Josephson Psychological Services
• Aaron Braden
• Bradford L. Stevens Psychology, P.C.
• Catherine Elaine Bradford, M.S., CCC-SLP

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.