NPIMap

Organization Active NPI

Bradford Orthopaedic & Sports Medicine Group, PC

  • Orthopaedic Surgery Physician
  • Bradford, PA
National Provider Identifier
1679535041
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BRADFORD ORTHOPAEDIC & SPORTS MEDICINE GROUP, PC
Practice address
54 Boylston St
2ND Floor
Bradford, PA 16701-2007
Phone
(814) 368-1020
Fax
(814) 368-1024
NPI assigned
Apr 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Authorized official

Name
Dr. Shabir Bhayani, MD
Title
Physician
Phone
(814) 368-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

54 Boylston St
2ND Floor
Bradford, PA 16701-2007

Mailing address

54 Boylston St
2ND Floor
Bradford, PA 16701-2007
Phone (814) 368-1020

Other identifiers 3

IdentifierTypeStateIssuer
CN8714OtherPARAILROAD MEDICARE
0019092890005MedicaidPA
CN8715OtherNYRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

195 Pleasant St
Bradford, PA 16701
Phone (814) 362-4966

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1679535041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 BOYLSTON ST",
            "address_2": "2ND FLOOR",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167012007",
            "telephone_number": "814-368-1020",
            "fax_number": "814-368-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 BOYLSTON ST",
            "address_2": "2ND FLOOR",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167012007",
            "telephone_number": "814-368-1020",
            "fax_number": "814-368-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD ORTHOPAEDIC & SPORTS MEDICINE GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "BHAYANI",
        "authorized_official_first_name": "SHABIR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "814-368-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN8714",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019092890005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN8715",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.