NPIMap

Individual provider Active NPI

Bradley James Massey, D.O.

  • Family Medicine Physician
  • Troy, MO
National Provider Identifier
1639164502
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
111051 Issued in MO
Practice address
1003 E Cherry St
Troy, MO 63379-1503
Phone
(636) 528-6755
Fax
(636) 528-6965
NPI assigned
Sep 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 111051 MO Primary

Addresses

Primary practice location

1003 E Cherry St
Troy, MO 63379-1503

Mailing address

PO Box 249
Troy, MO 63379-0249
Phone (636) 528-6755

Other identifiers 1

IdentifierTypeStateIssuer
244688321MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20050822000368 MO Practitioner - Family Practice 5395775159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital LincolnGroup PAC ID 5193040020, 31 clinicians

Practice addresses (Care Compare)

1003 E Cherry St
Troy, MO 63379-1503
Phone (636) 528-6755

35 Winfield PLZ
Winfield, MO 63389-3451
Phone (636) 668-6824

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
111051MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Lincoln CurrentSince Apr 18, 2015 Accepting new patients
Mercy Hospital Lincoln Family Medicine CurrentSince Apr 18, 2015 Accepting new patients

Locations

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

1003 E Cherry St
Troy, MO 63379
Phone (636) 528-6755

35 Winfield Plz
Winfield, MO 63389
Phone (636) 668-6824

Interoperability endpoints

  • Direct secure messaging: bmassey755318@directc.mercy.net

Ownership & related parties

All facility ownership & control disclosures 7

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

FacilityTypeRoleSince
Mercy Hospital LincolnTroy, MO, CCN 261319 Hospital Corporate Director Jul 1, 2020
Mercy Hospital LincolnTroy, MO, CCN 26Z319 Hospital Corporate Director Jul 1, 2020
Mercy Hospital Lincoln-Family Medicine and Psychiatry TroyTroy, MO, CCN 263479 Rural health clinic Corporate Director Jul 1, 2020
Mercy Hospital Lincoln-Family MedicineTroy, MO, CCN 268687 Rural health clinic Corporate Director Jul 1, 2020
Mercy Hospital Lincoln-Family Medicine WinfieldWinfield, MO, CCN 268701 Rural health clinic Corporate Director Jul 1, 2020
Mercy Hospital Lincoln- Family MedicineTroy, MO, CCN 263457 Rural health clinic Corporate Director Jul 1, 2020
Mercy Hospital Lincoln Family Medicine ElsberryElsberry, MO, CCN 268663 Rural health clinic Corporate Director Jul 1, 2020

Owned or controlled facilities with NPI records 7

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1639164502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633790249",
            "telephone_number": "636-528-6755",
            "fax_number": "636-528-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791503",
            "telephone_number": "636-528-6755",
            "fax_number": "636-528-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSEY",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "111051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244688321",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.