Individual provider Active NPI

Bradley Shaun Hillyard, MD

  • Student in an Organized Health Care Education/Training Program
  • Valhalla, NY
National Provider Identifier
1679215131
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
100 Woods Rd RM 2393
Valhalla, NY 10595-1530
Phone
(435) 890-8374
NPI assigned
Apr 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ Primary

Addresses

Primary practice location

100 Woods Rd RM 2393
Valhalla, NY 10595-1530

Mailing address

3300 N Triumph Blvd Ste G50
Lehi, UT 84043-6480
Phone (801) 990-1911

Other practice location 1

5121 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 990-1911

Other practice location 2

1441 N 12th St Fl 2
Phoenix, AZ 85006-2837
Phone (602) 521-5969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Anesthesia LLC Past Accepting new patients

Organizations & group practices 1

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": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1679215131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 N TRIUMPH BLVD STE G50",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840436480",
            "telephone_number": "801-990-1911",
            "fax_number": "914-493-7927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WOODS RD RM 2393",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951530",
            "telephone_number": "435-890-8374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5121 S Cottonwood St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841075701",
            "country_code": "US",
            "telephone_number": "801-990-1911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1441 N 12th St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062837",
            "country_code": "US",
            "telephone_number": "602-521-5969",
            "fax_number": "602-521-5987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILLYARD",
        "first_name": "BRADLEY",
        "middle_name": "SHAUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-13",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.