Shayne D Bradford, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C0001923 Issued in MD

Practice address

7505 Osler Dr
Suite 506
Towson, MD 21204-7736

Phone

(410) 581-1600

NPI assigned

Mar 31, 2006

Last updated

May 6, 2014By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

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, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifebridge Community Physicians IncGroup PAC ID 3678751468, 183 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040

Merit-based Incentive Payment System (MIPS)

Final score

83.23 of 100Reported as group

Quality

60.26

Promoting interoperability

100

Improvement activities

40

Cost

76.75

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/136fea15-c667-40bc-9ed2-b1115d62123b/

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.

• Lifebridge Community Physicians, Inc

  • Cardiovascular Disease Physician
  • Timonium, MD
  • NPI 1174815807
  Medicare reassignment Care Compare group NPD (past)
• Northwest Hospital Center, Inc

  dba NW Breast Care Ctr,Hospitalist,PA, SHS Plastics,Surgical House Staff

  • Hospitalist Physician
  • Randallstown, MD
  • NPI 1508961988
  Medicare reassignment NPD
• Baltimore Washington Emergency Physicians, Inc.

  • Emergency Medicine Physician
  • Glen Burnie, MD
  • NPI 1215983853
  Medicare reassignment
• Chesapeake Urology Associates, LLC

  dba Chesapeake Oncology Hematology Associates

  • Hematology & Oncology Physician
  • Stevensville, MD
  • NPI 1467337337
  Medicare reassignment
• Chesapeake Urology Associates LLC

  • Urology Physician
  • Owings Mills, MD
  • NPI 1609823004
  NPD
• Chesapeake Urology Associates, LLC

  • Urology Physician
  • Pikesville, MD
  • NPI 1124843990
  NPD
• Lifebridge Community Physicians Inc

  • Cardiovascular Disease Physician
  • Lutherville, MD
  • NPI 1740086149
  NPD
• Lifebridge Community Physicians, Inc

  dba Advanced Cardiology of Carroll County

  • Cardiovascular Disease Physician
  • Westminster, MD
  • NPI 1609150242
  NPD
• Northwest Hospital Center, Inc.

  dba Chronic Disease Clinic

  • Acute Care Nurse Practitioner
  • Randallstown, MD
  • NPI 1235669599
  NPD
• Lifebridge Community Physicians, Inc

  dba LifeBridge Community Pulmonology LLC

  • Pulmonary Disease Physician
  • Pikesville, MD
  • NPI 1306182621
  NPD (past)
• Midatlantic Cardiovascular Associates PA

  • Cardiovascular Disease Physician
  • Baltimore, MD
  • NPI 1821084112
  NPD (past)
• Northwest Hospital Center, Inc

  dba Northwest Wound Clinic

  • Surgery Physician
  • Randallstown, MD
  • NPI 1447354790
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northwest Hospital Center, Inc.

  • General Acute Care Hospital
  • Randallstown, MD
  • NPI 1487695888
  Care Compare affiliation

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399334400000",
    "number": "1841251386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR",
            "address_2": "SUITE 306",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175421",
            "telephone_number": "443-738-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 OSLER DR",
            "address_2": "SUITE 506",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047736",
            "telephone_number": "410-581-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "SHAYNE",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2014-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C0001923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE GROUP #",
            "identifier": "CN6601",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE PROVIDER #",
            "identifier": "970005969",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanika Dawn Bowman
• Susan P Boyer, PHD
• Autumn Boyle, LGPC
• Karen Elizabeth Boyle, M.D.
• Zackary Paul Boyles, PT, DPT
• Brian Bradshaw, MS, ATC
• Amy Bram, RN
• Mary Katherine Bramhall, LGPC
• Kenneth Branamen
• Andrea Brand, MAC, LAC

• Surgical Physician Assistant in Towson, MD
• Providers in Towson, MD by specialty
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.