Bradley Lasley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9111766 Issued in FL

Practice address

2005 Mizell Ave Ste 2100
Winter Park, FL 32792-4126

Phone

(407) 599-6460

Fax

(407) 599-6461

NPI assigned

Feb 4, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blasley73721@adventhealth.direct-ci.com

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.

• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234

  Physician Assistant

  NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1568885077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 MIZELL AVE STE 2100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924126",
            "telephone_number": "407-599-6460",
            "fax_number": "407-599-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 MIZELL AVE STE 2100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924126",
            "telephone_number": "407-599-6460",
            "fax_number": "407-599-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASLEY",
        "first_name": "BRADLEY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-04",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "5606",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9111766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiney Larkin
• Justyne Deena Larson, BCBA
• Leslie Ann Larson
• Maria C. Lasalle, SLP
• Roberta Lashinger
• Latching in Love LLC
• Naseem Bano Latif, MD
• Annabella S Latotzke, DPT, ATC, LAT, MTC
• Elizabeth Anne Latsa, OTR/L
• David Matthew Laughlin, MA, LMHC

• Physician Assistant in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.