Ryan Bradley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1128591 Issued in AZ

Practice address

5880 N Hospital Dr
Globe, AZ 85501

Phone

(928) 425-3247

NPI assigned

Sep 21, 2015

Last updated

Sep 21, 2015By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

At Still University, Arizona School of Dentistry & Oral HLTH, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alevea Mental Health LLCGroup PAC ID 6608135652, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Alevea Mental Health LLC

  • Physician Assistant
  • Tempe, AZ
  • NPI 1619482478
  Medicare reassignment Care Compare group
• Cobre Valley Regional Medical Center

  • Critical Access Hospital
  • Globe, AZ
  • NPI 1871566521
  Medicare reassignment
• La Laser Center, PC, a Professional Medical Corporation

  • Multi-Specialty Clinic/Center
  • San Clemente, CA
  • NPI 1306982855

  AZ

  Medicare reassignment
• Cobre Valley Regional Medical Center

  dba Cobre Valley Surgical Services

  • Rural Health Clinic/Center
  • Globe, AZ
  • NPI 1538315890
  NPD
• Cobre Valley Regional Medical Center

  • Community/Retail Pharmacy
  • Globe, AZ
  • NPI 1639384233
  NPD

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1790154664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 N HOSPITAL DR",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "85501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 N HOSPITAL DR",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "85501",
            "telephone_number": "928-425-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1128591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billet Hospice Inc - Globe
• Gretchen Boise, MD
• Bonneville Med PC
• Cyrus C Bowers, D.O.
• Karrol Braddock, PT
• Ashley Bravo, NP
• Todd Ray Brewster, P.T.
• Mars Brimhall, CRNA
• Robin Broz, D.O.
• Anthony Giacomo Brusca, DDS

• Physician Assistant in Globe, AZ
• Providers in Globe, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.