Cali J Bradberry, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-937 Issued in ID

Practice address

4750 N Five Mile Rd
Boise, ID 83713-2715

Phone

(208) 375-0500

Fax

(208) 375-4310

NPI assigned

Oct 5, 2011

Last updated

Feb 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dwyer and Harrington, PLLCGroup PAC ID 4981838711, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Dwyer & Harrington, PLLC

  dba Omega Mental Health

  • Nurse Practitioner
  • Boise, ID
  • NPI 1568589596
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1831473198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5985 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033039",
            "telephone_number": "208-853-0071",
            "fax_number": "208-853-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132715",
            "telephone_number": "208-375-0500",
            "fax_number": "208-375-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBERRY",
        "first_name": "CALI",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-937",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-937",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "PA-937",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BP Consulting, Inc (Perspectives Imaging)
• Bpa Health
• Danielle Brachman, DPT
• Tess Brackett, DPT
• Aaron W Brackney, D.O.
• Zachary Braddock, PT, DPT
• Braden M. Stauts DDS LLC
• Velma Susan Bradford, M.D.
• Dana Bradley, LCPC
• Jenna Marie Bradley, AU.D.

• Medical Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.