Phillip Moses Bridgman, M.D.

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

166862-1 Issued in NY

Practice address

50 Leroy Street
Potsdam, NY 13676

Phone

(315) 265-3300

NPI assigned

Dec 21, 2006

Last updated

Sep 13, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Hermon Family Health Care

  • Family Medicine Physician
  • Hermon, NY
  • NPI 1811057367
  NPD (past)
• Saint Lawrence Pathology PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Potsdam, NY
  • NPI 1225514615
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1598829582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 PATTERSON ST",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136693840",
            "telephone_number": "315-393-9113",
            "fax_number": "315-393-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEROY STREET",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "13676",
            "telephone_number": "315-265-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGMAN",
        "first_name": "PHILLIP",
        "middle_name": "MOSES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "NY",
            "license": "166862-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "166862-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridget Bond, RN
• Gwen Lindsey Bonner, M.D.
• Megan Lyn Boyea, CCC-SLP
• Emma Brackett, LCSW
• Brent S. Knight - Knight & Associates Physical Therapy (Knight & Associates Physical Therapists)
• William Bronner VI, PA-C
• Aundrea Bronson
• Elizabeth Browning, RN
• Bruce J Rogers (Potsdam Optical Center)
• Linda Helene Buchanan, R,D,

• Clinical Pathology/Laboratory Medicine Physician in Potsdam, NY
• Providers in Potsdam, NY by specialty
• Clinical Pathology/Laboratory Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.