Bradley J Wallrath, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9107050 Issued in FL

Practice address

5430 Military TRL Ste 64
Jupiter, FL 33458-2873

Phone

(561) 263-7010

NPI assigned

Mar 6, 2013

Last updated

Mar 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jupiter Medical Center Physicians Group IncGroup PAC ID 4284797069, 151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwallrath21713@jupitermedicalcenter.direct-ci.com
• FHIR API: https://epicrp.jupitermed.com/oauth2-prd/api/FHIR/R4/
• FHIR API: https://fhir4.healow.com/fhir/r4/FCGJBD

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.

• Jupiter Medical Center Physicians Group Inc

  • Cardiovascular Disease Physician
  • Jupiter, FL
  • NPI 1396992475
  Medicare reassignment Care Compare group
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment
• Jupiter Medical Center Physicians Group

  dba Jupiter Medical Center Urgent Care

  • Urgent Care Clinic/Center
  • Palm Beach Gardens, FL
  • NPI 1386196707
  NPD
• Jupiter Medical Center Physicians Group Inc

  dba JMC Community Care

  • Pediatric Surgery Physician
  • Jupiter, FL
  • NPI 1093344376
  NPD
• University of Florida Jacksonville Physicians Inc

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1588824858
  NPD
• University of Florida Jacksonville Physicians, Inc.

  dba UF Health Imaging Center-Baymeadows

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jupiter Medical Center, Inc.

  • General Acute Care Hospital
  • Jupiter, FL
  • NPI 1295721090
  Care Compare affiliation

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

{
    "created_epoch": "1362528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1720329485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9218",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334689218",
            "telephone_number": "561-263-7270",
            "fax_number": "561-263-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 MILITARY TRL STE 64",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582873",
            "telephone_number": "561-263-7010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10131 Forest Hill Blvd Ste 206",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334146109",
            "country_code": "US",
            "telephone_number": "561-798-6600",
            "fax_number": "561-753-3328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLRATH",
        "first_name": "BRADLEY",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-06",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107050",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9107050",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003134530A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008416700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Walker, M.A. CCC-SLP
• Kurt E Walker, AU.D.
• Jonathan Keith Wall, MSW
• Robyn Lynn Wallace, PH.D
• Shawn Waller, DPT
• Maryann Walsh, R.D.
• Wanuck, Hier & Associates
• Warburton Frey & Associates P a
• Code J Ward Bringas, RBT
• Sharon Joy Warwick, P.T.

• Physician Assistant in Jupiter, FL
• Providers in Jupiter, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.