Bradley J Phillips MD LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

25MA06584600 Issued in NJ

Legal business name

BRADLEY J PHILLIPS MD LLC

Practice address

1543 Route 27
Suite 23
Somerset, NJ 08873

Phone

(732) 249-6101

Fax

(732) 249-6102

NPI assigned

May 14, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Bradley J Phillips, M.D.NPI 1104800143

Title

Senior Adminstrator/President

Phone

(732) 249-6101

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley J. Phillips, M.D.

  • Ophthalmology Physician
  • Brooklyn, NY
  • NPI 1104800143

  NJ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1821265349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7063",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089027063",
            "telephone_number": "732-249-6101",
            "fax_number": "732-249-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 ROUTE 27",
            "address_2": "SUITE 23",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "08873",
            "telephone_number": "732-249-6101",
            "fax_number": "732-249-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY J PHILLIPS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SENIOR ADMINSTRATOR/PRESIDENT",
        "authorized_official_telephone_number": "732-249-6101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA06584600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7384009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suni Bolar, DDS
• Elizabeth Ann Bolton, MS
• Arlene Bonapace, PSYD
• Carmen Yolanda Bonta, DMD
• Rebecca Bortman, BCBA
• Deepa Brahmabhatt, PHARMD
• Dolphus Brantley III
• Edy Braun, DDS
• Breath of Life Counseling Services, LLC
• Samantha Lynn Breeman, BCBA-D

• Ophthalmology Physician in Somerset, NJ
• Providers in Somerset, NJ by specialty
• Ophthalmology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.