NPIMap

Individual provider Active NPI

Marcella W Bradway, M.D.

  • Colon & Rectal Surgery Physician
  • Pittsfield, MA
National Provider Identifier
1669478657
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
037814 Issued in CT
Practice address
777 North St
Suite 605
Pittsfield, MA 01201-4147
Phone
(413) 447-2745
Fax
(413) 346-6703
NPI assigned
Jun 23, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 037814 CT Primary

Addresses

Primary practice location

777 North St
Suite 605
Pittsfield, MA 01201-4147

Mailing address

93 Ridge Ave
Pittsfield, MA 01201-1442
Phone (413) 447-2745

Other identifiers 1

IdentifierTypeStateIssuer
001378141MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20081120000100 MA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 5193885135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
University of Massachusetts Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Berkshire Faculty Services Inc 276 clinicians

Practice addresses (Care Compare)

777 N St 6TH Floor
Colon and Rectal Surgical Professional Serv
Pittsfield, MA 01201-4147
Phone (413) 447-2859

Hospital & facility affiliations

  • Berkshire Visiting Nurse Association Home health agency, Pittsfield, MA, CCN 227122
  • Berkshire Medical Center Hospital, Pittsfield, MA, CCN 220046
  • Fairview Hospital Hospital, Great Barrington, MA, CCN 221302
  • North Adams Regional Hospital Corporation Hospital, North Adams, MA, CCN 221304

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy143
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
037814CTMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Berkshire Faculty Services Inc CurrentSince Mar 1, 2019 Accepting new patients
Fairview Hospital CurrentSince Mar 1, 2019 Accepting new patients
Berkshire Medical Center, Inc Past Accepting new patients
Colon Andrectal Surgeons of Fairfield County, LLC Colon & Rectal Surgery Past Accepting new patients
Fairview Hospital PastSince Feb 10, 2015 Accepting new patients
Hillcrest Family Health Center Past Accepting new patients

Locations

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

777 North St
Ste 201A
Pittsfield, MA 01201
Phone (413) 499-8551

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

Interoperability endpoints

  • Direct secure messaging: marcellabradway@bfs.medalliesdirect.net

Organizations & group practices 6

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 4

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1669478657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 RIDGE AVE",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012011442",
            "telephone_number": "413-447-2745",
            "fax_number": "413-346-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 NORTH ST",
            "address_2": "SUITE 605",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014147",
            "telephone_number": "413-447-2745",
            "fax_number": "413-346-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADWAY",
        "first_name": "MARCELLA",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CT",
            "license": "037814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001378141",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.