Individual provider Active NPI

Bradley George Peltier, M.D.

  • Anesthesiology Physician
  • Corpus Christi, TX
National Provider Identifier
1588657589
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G5470 Issued in TX
Practice address
6130 Parkway Dr
Corpus Christi, TX 78414-2455
Phone
(361) 883-6211
Fax
(361) 882-4891
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G5470 TX Primary

Addresses

Primary practice location

6130 Parkway Dr
Corpus Christi, TX 78414-2455

Mailing address

4455 S Padre Island Dr Ste 11
Corpus Christi, TX 78411-5163
Phone (361) 883-6211

Other identifiers 1

IdentifierTypeStateIssuer
1204190 01MedicaidTX

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101104001287 TX Practitioner - Anesthesiology 6901795574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Medical Branch at Galveston, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf Shore Anesthesia Associates PAGroup PAC ID 3173412806, 17 clinicians

Practice addresses (Care Compare)

6130 Pkwy Dr
Corpus Christi, TX 78414-2455
Phone (361) 993-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G5470TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Shore Anesthesia Associates PA Anesthesiology CurrentSince Nov 3, 1983 Accepting new patients
Northstar Anesthesia II PA Anesthesiology CurrentSince Jun 1, 2018 Accepting new patients

Locations

7101 S Padre Island Dr
Corpus Christi, TX 78412
Phone (361) 761-1400

613 Elizabeth St
Ste 605
Corpus Christi, TX 78404
Phone (361) 883-1094

6130 Parkway Dr
Corpus Christi, TX 78414
Phone (361) 826-5785

4455 S Padre Island Dr
Ste 11
Corpus Christi, TX 78411
Phone (361) 855-8900

1734 Santa Fe St
Corpus Christi, TX 78404
Phone (361) 882-4891

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1588657589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 S PADRE ISLAND DR STE 11",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784115163",
            "telephone_number": "361-883-6211",
            "fax_number": "361-882-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6130 PARKWAY DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784142455",
            "telephone_number": "361-883-6211",
            "fax_number": "361-882-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTIER",
        "first_name": "BRADLEY",
        "middle_name": "GEORGE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "G5470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1204190 01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.