Individual provider Active NPI

Bradley Paul Jenkins, DPT

  • Physical Therapist
  • Mayfield Heights, OH
National Provider Identifier
1629035233
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
OH-8844 Issued in OH
Practice address
1430 Som Center Rd Ste 1
Mayfield Heights, OH 44124-2123
Phone
(440) 442-7111
Fax
(440) 460-1767
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X OH-8844 OH Primary

Addresses

Primary practice location

1430 Som Center Rd Ste 1
Mayfield Heights, OH 44124-2123

Mailing address

PO Box 378
Sandusky, OH 44871-0378
Phone (419) 626-6161

Other identifiers 1

IdentifierTypeStateIssuer
2361779MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060717000213 OH Practitioner - Physical Therapist in Private Practice 3870506801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Ohio Medical Specialists,LLC 252 clinicians

Practice addresses (Care Compare)

26151 Euclid Ave
Suite 105
Euclid, OH 44132-3300
Phone (440) 442-3113

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
59.13
Promoting interoperability
99
Improvement activities
40
Cost
75.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OH-8844OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists, LLC CurrentSince Apr 29, 2020 Accepting new patients
Northern Ohio Medical Specialists LLC CurrentSince Apr 29, 2020 Accepting new patients
Orthopedic Associates of Lake Co Inc Past Accepting new patients
Alternative Healthcare Solutions Inc. Physical Therapist PastSince May 21, 1999 Accepting new patients
Agm Physical Therapy, LLC PastSince Apr 16, 2013 Accepting new patients
Northern Ohio Medical Specialists, LLC PastSince May 17, 2020 Accepting new patients
Lake Hospital System, Inc Past Accepting new patients

Locations

26151 Euclid Ave
Ste 105
Euclid, OH 44132
Phone (440) 442-3113

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1629035233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448710378",
            "telephone_number": "419-626-6161",
            "fax_number": "419-502-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 SOM CENTER RD STE 1",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441242123",
            "telephone_number": "440-442-7111",
            "fax_number": "440-460-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "BRADLEY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "OH-8844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2361779",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.