Active NPI
Susan M Bradley-Boehme, DMD
- Dentist
- Carnegie, PA
National Provider Identifier
1861592230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS024633L
- Practice address
- 312 2ND Ave
Carnegie, PA 15106-2509 - Phone
- (412) 279-7366
- Fax
- (412) 279-7366
- NPI assigned
- Sep 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS024633L | PA | Primary |
Addresses
Primary practice location
312 2ND Ave
Carnegie, PA 15106-2509
Mailing address
103 Cedarbrook CT
McMurray, PA 15317
Phone (724) 942-4551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150619000962 | PA | Order and Referring Only - Dentist | 7911218771 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS024633L | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Penn Dental Center LLC | Dentist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Dentist
- Carnegie, PA
- NPI 1912024159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331164800000",
"number": "1861592230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 CEDARBROOK CT",
"city": "MCMURRAY",
"state": "PA",
"postal_code": "15317",
"telephone_number": "724-942-4551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 2ND AVE",
"city": "CARNEGIE",
"state": "PA",
"postal_code": "151062509",
"telephone_number": "412-279-7366",
"fax_number": "412-279-7366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY-BOEHME",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-25",
"last_updated": "2012-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS024633L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carnegie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.