NPIMap

Individual provider Active NPI

Anil Pradhan, MD

  • Pediatrics Physician
  • Bradford, PA
National Provider Identifier
1639122609
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD081720E Issued in PA
Practice address
159 Interstate Pkwy
Bradford, PA 16701-1013
Phone
(716) 375-7500
NPI assigned
May 18, 2006
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD081720E PA Primary

Addresses

Primary practice location

159 Interstate Pkwy
Bradford, PA 16701-1013

Mailing address

159 Interstate Pkwy
Bradford, PA 16701-1013
Phone (716) 375-7500

Other identifiers 1

IdentifierTypeStateIssuer
0007774520003MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140401000219 PA Practitioner - Pediatric Medicine 5294966412 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD081720EPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Tier Community Health Center Network, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Southern Tier Community Health Center Network, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

135 N Union St
Olean, NY 14760

500 Main St
Olean, NY 14760
Phone (716) 373-2600

159 Interstate Pkwy
Bradford, PA 16701
Phone (814) 362-8480

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Olean General HospitalOlean, NY, CCN 33U103 Hospital Corporate Director Jan 1, 2019
Bradford Regional Medical CenterBradford, PA, CCN 33010301 Hospital Corporate Director Jan 1, 2022
Olean General HospitalBradford, PA, CCN 395355 Skilled nursing facility Corporate Director Jan 1, 2022
Olean General HospitalSmethport, PA, CCN 393421 Rural health clinic Corporate Director Jan 1, 2022
Olean General HospitalBradford, PA, CCN 393420 Rural health clinic Corporate Director Jan 1, 2022
Olean General HospitalBradford, PA, CCN 393422 Rural health clinic Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1639122609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 INTERSTATE PKWY",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011013",
            "telephone_number": "716-375-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 INTERSTATE PKWY",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011013",
            "telephone_number": "716-375-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRADHAN",
        "first_name": "ANIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD081720E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007774520003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, PA

Sources for this page

Verify at the official NPI Registry.