NPIMap

Individual provider Active NPI

Bradley Mark Ceremuga, D.O.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Spartanburg, SC
National Provider Identifier
1679957542
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
37663 Issued in SC
Practice address
225 E Wood St
Spartanburg, SC 29303-3050
Phone
(864) 560-4420
Fax
(864) 560-5296
NPI assigned
Jul 10, 2015
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 37663 SC Primary

Addresses

Primary practice location

225 E Wood St
Spartanburg, SC 29303-3050

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other practice location 1

201 Abraham Flexner Way Ste 1200
Louisville, KY 40202-3841
Phone (502) 588-7600

Other identifiers 2

IdentifierTypeStateIssuer
SCM9985019OtherSCMEDICARE PIN
376630MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220623001697 SC Practitioner - General SurgeryPractitioner - Thoracic Surgery 0941517130 Reassigns benefits to 1 organization
I20260506000939 CO Practitioner - Thoracic Surgery 0941517130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

225 E Wood St
Spartanburg, SC 29303-3050
Phone (864) 583-4420

2635 N 7TH St
Grand Junction, CO 81501-8209

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37663SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Jun 7, 2022 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Jun 7, 2022 Accepting new patients
Spartanburg Medical Center Past Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

225 E Wood St
Spartanburg, SC 29303
Phone (864) 560-4420

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1679957542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E WOOD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033050",
            "telephone_number": "864-560-4420",
            "fax_number": "864-560-5296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Abraham Flexner Way Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023841",
            "country_code": "US",
            "telephone_number": "502-588-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CEREMUGA",
        "first_name": "BRADLEY",
        "middle_name": "MARK",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-10",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "SC",
            "license": "37663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCM9985019",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376630",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.