Individual provider Active NPI

Elijah Bradley Drummond, PA-C

  • Surgical Physician Assistant
  • Bridgeport, WV
National Provider Identifier
1760133946
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
2728 Issued in WV
Practice address
227 Medical Park Dr
Bridgeport, WV 26330-8420
Phone
(681) 342-3500
NPI assigned
Jan 10, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2728 WV Primary

Addresses

Primary practice location

227 Medical Park Dr
Bridgeport, WV 26330-8420

Mailing address

4022 Meadowbrook Rd
Bridgeport, WV 26330-7272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20230901001759 WV Practitioner - Physician Assistant 2769845171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Hospital Center IncGroup PAC ID 8123936010, 290 clinicians

Practice addresses (Care Compare)

107 Staunton Dr
Weston, WV 26452-5604
Phone (681) 342-3570

327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1842

916 W Main St
Bridgeport, WV 26330-1651
Phone (304) 842-1034

PO Box
Suite 775
Morgantown, WV 26507-0775

Hospital & facility affiliations

  • United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006
  • St Joseph'S Hospital of Buckhannon, Inc Hospital, Buckhannon, WV, CCN 511321

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2728WVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
United Hospital Center, Inc. CurrentSince Jul 22, 2023 Accepting new patients
Wvu Medical Corporation PastSince Jul 28, 2024 Accepting new patients

Locations

916 W Main St
Bridgeport, WV 26330
Phone (304) 842-1034

327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000

227 Medical Park Dr
Ste 101
Bridgeport, WV 26330
Phone (681) 342-3490

2673 Davisson Run Rd
Ste 303
Clarksburg, WV 26301

107 Staunton Dr
Weston, WV 26452
Phone (304) 269-2022

Organizations & group practices 2

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 2

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": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1760133946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 MEADOWBROOK RD",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263307272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MEDICAL PARK DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263308420",
            "telephone_number": "681-342-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUMMOND",
        "first_name": "ELIJAH",
        "middle_name": "BRADLEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-10",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WV",
            "license": "2728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.