Individual provider Active NPI

Bradley B Andrew, P.A.

  • Physician Assistant
  • American Fork, UT
National Provider Identifier
1801013230
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6546889-1206 Issued in UT
Practice address
52 N 1100 E
American Fork, UT 84003-2952
Phone
(801) 769-0901
Fax
(801) 769-0903
NPI assigned
Apr 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6546889-1206 UT Primary

Addresses

Primary practice location

52 N 1100 E
American Fork, UT 84003-2952

Mailing address

52 N 1100 E
American Fork, UT 84003-2952
Phone (801) 769-0901

Other identifiers 1

IdentifierTypeStateIssuer
6546889-1206OtherUTSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20070920000071 UT Practitioner - Physician Assistant 4082708169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurological Associates LLCGroup PAC ID 1153306360, 5 clinicians

Practice addresses (Care Compare)

212 S 1100
American Fork, UT 84003-2829
Phone (801) 763-0901

498 E 800
Suite 3B
Orem, UT 84097-4144
Phone (801) 763-0901

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6546889-1206UTMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: neurologicalassociates.andrewbradley@156511.advancedmd-direct.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801013230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 N 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032952",
            "telephone_number": "801-769-0901",
            "fax_number": "801-769-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 N 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032952",
            "telephone_number": "801-769-0901",
            "fax_number": "801-769-0903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREW",
        "first_name": "BRADLEY",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "6546889-1206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "6546889-1206",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.