Individual provider Active NPI

Sicily A Bradley, M.D.

  • Internal Medicine Physician
  • Loma Linda, CA
National Provider Identifier
1619267366
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A129501 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 558-4000
NPI assigned
Apr 14, 2011
Last updated
Jan 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A129501 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St
Loma Linda, CA 92354-2804
Phone (909) 558-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140825000781 CA Practitioner - Internal MedicinePractitioner - Hospitalist 6507084167 Reassigns benefits to 4 organizations
I20240509004094 HI Practitioner - Hospitalist 6507084167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

91 -2135 Fort Weaver Rd
Suite 150
Ewa Beach, HI 96706-1929
Phone (808) 691-3020

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A129501CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Internal Medicine Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Galen Inpatient Physicians PC CurrentSince Jul 1, 2022 Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 8, 2017 Accepting new patients
Amplehealth Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Permanente Medical Group Inc Internal Medicine CurrentSince Nov 8, 2017 Accepting new patients
Galen Inpatient Physicians, PC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2014 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2014 Accepting new patients
Galen Inpatient Physicians, PC Current Accepting new patients
1125 Sir Francis Drake Boulevard Operating Company, LLC CurrentSince Jul 1, 2022 Accepting new patients
Queens University Medical Group CurrentSince Apr 1, 2024 Accepting new patients
The Queens Medical Center Past Accepting new patients
The Queen's Medical Center Past Accepting new patients

Locations (25 of 32)

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

6620 Coyle Ave
Ste 202
Carmichael, CA 95608
Phone (916) 961-3434

6620 Coyle Ave
Ste 302
Carmichael, CA 95608
Phone (916) 966-8500

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1900 Dresden Dr
Lincoln, CA 95648
Phone (916) 543-5153

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

3270 Arena Blvd
Ste 405
Sacramento, CA 95834
Phone (916) 418-4595

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Organizations & group practices 14

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.

View all 14

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": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1619267366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "SICILY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-14",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A129501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1900 Dresden Dr",
            "city": "Lincoln",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956488803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.