Bradley Davis, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB10217800 Issued in NJ

Practice address

539 US Highway 9
Lanoka Harbor, NJ 08734-2211

Phone

(609) 549-6266

Fax

(609) 549-5600

NPI assigned

May 20, 2014

Sex

Male

Sole proprietor

No

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.

• Summit Medical Group PA

  • Multi-Specialty Clinic/Center
  • Berkeley Heights, NJ
  • NPI 1942254347

  NJ

  Medicare reassignment Care Compare group NPD
• Doctor'S Office of West Caldwell LLC

  • Urgent Care Clinic/Center
  • West Caldwell, NJ
  • NPI 1144524786

  NJ

  Medicare reassignment NPD
• Doctors Office of Brick

  • Urgent Care Clinic/Center
  • Brick, NJ
  • NPI 1184067944

  NJ

  Medicare reassignment NPD
• Excel Urgent Care of NJ LLC

  • Urgent Care Clinic/Center
  • Old Bridge, NJ
  • NPI 1255742243

  NJ

  Medicare reassignment NPD
• Hackensack Meridian Urgent Care, PC

  • Urgent Care Clinic/Center
  • Freehold, NJ
  • NPI 1285165209

  NJ

  Medicare reassignment NPD
• Jersey Irish Medical

  • Urgent Care Clinic/Center
  • Bound Brook, NJ
  • NPI 1144575739

  Family Medicine, NJ

  Medicare reassignment NPD
• Prohealth Urgent Care Medicine of New Jersey LLP

  • Emergency Care Clinic/Center
  • Edgewater, NJ
  • NPI 1477927754

  NJ

  Medicare reassignment NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1043930555
  Care Compare group NPD
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Florham Park, NJ
  • NPI 1013738863
  Care Compare group
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • Morristown, NJ
  • NPI 1043947963
  Care Compare group
• Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • West Orange, NJ
  • NPI 1093436404
  Care Compare group
• Summit Medical Group PA

  • Ambulatory Surgical Clinic/Center
  • Voorhees, NJ
  • NPI 1093444010
  Care Compare group

Specialty

Family Practice

Education

West Virginia School of Osteopathic Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Medical Group PA 1,204 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hackensackmeridian.bradleydavis@136290.advancedmd-direct.com
• Direct secure messaging: bradley.davis.1@2983.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 24, 2023.

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1790197101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 US HIGHWAY 9",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087342211",
            "telephone_number": "609-549-6266",
            "fax_number": "609-549-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRADLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-20",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB10217800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0613886",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Rice Chapman, M.A., PH.D.
• Cheryl a Byk LCSW LLC
• Norma Chinique-Feaster, B.A.
• Comprehensive Medical Assoc
• Patricia Csupa, RN, BSN, NC-CD
• Eulalia Dibattiste, M.D.
• Jennifer Didino, NAVIGATOR
• Dominick Deblasio
• Christina Beth Duggan, LCSW ACSW
• Lovell Edwin Emery Jr., M.ED.,A.T.C

• All providers in Lanoka Harbor, NJ
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; 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.