NPIMap

Individual provider Active NPI

Bradley Harold Staehle, M.D.

  • Diagnostic Radiology Physician
  • Hartford, CT
National Provider Identifier
1578521522
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
042159 Issued in CT
Practice address
19 Woodland St
Suite 15
Hartford, CT 06105-2372
Phone
(860) 522-1101
Fax
(860) 549-7092
NPI assigned
May 1, 2006
Last updated
Feb 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 042159 CT Primary

Addresses

Primary practice location

19 Woodland St
Suite 15
Hartford, CT 06105-2372

Mailing address

19 Woodland St
Suite 15
Hartford, CT 06105-2372
Phone (860) 522-1101

Other identifiers 1

IdentifierTypeStateIssuer
001421594MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040524000555 CT Practitioner - Diagnostic Radiology 2567453939 Reassigns benefits to 3 organizations
I20151130001779 MA Practitioner - Diagnostic Radiology 2567453939 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology and Imaging IncGroup PAC ID 9234110479, 58 clinicians

Practice addresses (Care Compare)

113 Elm St
Suite 206
Enfield, CT 06082-3738
Phone (860) 741-2177

759 Chestnut St
Springfield, MA 01107-1619
Phone (413) 827-7400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042159CTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Nov 14, 2017 Accepting new patients
Franklin MRI Center LLC CurrentSince Apr 1, 2018 Accepting new patients
Tic, LLC Diagnostic Radiology CurrentSince Sep 1, 2016 Accepting new patients
Baystate MRI & Imaging Center, LLC CurrentSince Apr 1, 2018 Accepting new patients
Radiology & Imaging Inc Diagnostic Radiology CurrentSince Apr 1, 2018 Accepting new patients
Connecticut Valley Radiology, PC PastSince Jul 1, 2004 Accepting new patients
United Imaging Consultants, LLC Diagnostic Radiology Past Accepting new patients
University Radiology Associates Diagnostic Radiology PastSince Feb 1, 1997 Accepting new patients

Locations

113 Elm St
Ste 206
Enfield, CT 06082
Phone (860) 741-2177

6 Fieldstone Cmns
Ste E
Tolland, CT 06084
Phone (860) 896-4847

11 Nevins St
Ste 202
Brighton, MA 02135
Phone (617) 254-9991

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

1350 Main St
Ste 1007
Springfield, MA 01103
Phone (413) 495-1100

759 Chestnut St
Springfield, MA 01107
Phone (413) 794-6297

115 W Silver St
Westfield, MA 01085
Phone (413) 562-3444

Interoperability endpoints

  • Direct secure messaging: bradley.staehle@xdr.hhchealthdirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1578521522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 WOODLAND ST",
            "address_2": "SUITE 15",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052372",
            "telephone_number": "860-522-1101",
            "fax_number": "860-549-7092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 WOODLAND ST",
            "address_2": "SUITE 15",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052372",
            "telephone_number": "860-522-1101",
            "fax_number": "860-549-7092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAEHLE",
        "first_name": "BRADLEY",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "042159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001421594",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.