Active NPI
Bradford Radiology PC
- Diagnostic Radiology Physician
- Bradford, PA
National Provider Identifier
1669056669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- BRADFORD RADIOLOGY PC
- Practice address
- 116 Interstate Pkwy
Bradford, PA 16701-1036 - Phone
- (814) 368-4143
- NPI assigned
- May 6, 2021
- Last updated
- Aug 21, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth Pearsen, MD
- Title
- MD
- Phone
- (716) 836-4646
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
116 Interstate Pkwy
Bradford, PA 16701-1036
Mailing address
111 N Maplemere Rd Ste 120
Williamsville, NY 14221-3178
Phone (716) 836-4646
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 27
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Vascular & Interventional Radiology Physician
- Williamsville, NY
- NPI 1861878837
Diagnostic Radiology, PA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620259200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1692576000000",
"number": "1669056669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N MAPLEMERE RD STE 120",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142213178",
"telephone_number": "716-836-4646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 INTERSTATE PKWY",
"city": "BRADFORD",
"state": "PA",
"postal_code": "167011036",
"telephone_number": "814-368-4143"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRADFORD RADIOLOGY PC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-06",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A",
"authorized_official_last_name": "PEARSEN",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "MD",
"authorized_official_telephone_number": "716-836-4646",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradford, PA
- Bradford Emergency Associates PC
- Bradford Family Medicine, Inc.
- Bradford Oncology LLC
- Bradford Orthopaedic & Sports Medicine Group, PC
- Bradford PA Opco LLC
- Bradford Regional Medical Center (McKean County VNA & Hospice)
- Bradford Regional Medical Center (McKean County Visting Nurse Association)
- Bradford Regional Medical Services
- Bradford Z Stat Ambulance, LLC.
- Bradford Z-Stat
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.