Individual provider Active NPI

Paul M. Braadt, DC

  • Chiropractor
  • Allentown, PA
National Provider Identifier
1861450934
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC001604L Issued in PA
Practice address
1028 S Cedar Crest Blvd
Allentown, PA 18103-5444
Phone
(610) 776-2005
Fax
(610) 776-1475
NPI assigned
May 1, 2006
Last updated
Aug 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC001604L PA Primary

Addresses

Primary practice location

1028 S Cedar Crest Blvd
Allentown, PA 18103-5444

Mailing address

1028 S Cedar Crest Blvd
Allentown, PA 18103-5444
Phone (610) 776-2005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100114000053 PA Practitioner - Chiropractic 1557402492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Braadt PC Chiropractor CurrentSince Oct 10, 2009 Accepting new patients
Cedar Crest Chiropractic LLC Chiropractor CurrentSince Nov 24, 2024 Accepting new patients

Locations

1028 S Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 776-2005

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1861450934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035444",
            "telephone_number": "610-776-2005",
            "fax_number": "610-776-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 S CEDAR CREST BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035444",
            "telephone_number": "610-776-2005",
            "fax_number": "610-776-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAADT",
        "first_name": "PAUL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC001604L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; 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.