Individual provider Active NPI

Oniqua D Bradwell, PA-C

  • Medical Physician Assistant
  • Landover Hills, MD
National Provider Identifier
1750627386
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C04230 Issued in MD
Practice address
6201 Annapolis Rd
Landover Hills, MD 20784-1307
Phone
(301) 276-3377
NPI assigned
Jan 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA030827 DC
Medical Physician Assistant 363AM0700X C04230 MD Primary

Addresses

Primary practice location

6201 Annapolis Rd
Landover Hills, MD 20784-1307

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (049) 685-7008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140804000124 DC Practitioner - Physician Assistant 2163649856 Reassigns benefits to 1 organization
I20150225000821 MD Practitioner - Physician Assistant 2163649856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Maryland LLCGroup PAC ID 4486900172, 178 clinicians

Practice addresses (Care Compare)

11890 Healing Way
Silver Spring, MD 20904-7917
Phone (240) 637-5070

Hospital & facility affiliations

  • Adventist Healthcare White Oak Medical Center Hospital, Silver Spring, MD, CCN 210016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA030827DCMDMedical Physician Assistant
C04230MDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc CurrentSince Dec 30, 2014 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Dec 30, 2014 Accepting new patients

Locations

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

8118 Good Luck Rd
Lanham Seabrook, MD 20706
Phone (301) 552-8608

Organizations & group practices 4

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 1

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": "1356998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1750627386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "049-685-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 ANNAPOLIS RD",
            "city": "LANDOVER HILLS",
            "state": "MD",
            "postal_code": "207841307",
            "telephone_number": "301-276-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADWELL",
        "first_name": "ONIQUA",
        "middle_name": "D",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-01",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA030827",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C04230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Landover Hills, MD

Sources for this page

Verify at the official NPI Registry.