Bradley A Andrews, MD
Individual provider Active NPI Otolaryngology Physician · Lone Tree, CO
NPI 1891822896 · NPPES record last updated Jun 14, 2021
Key facts
- NPI
- 1891822896
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Otolaryngology Physician 207Y00000X
- License
- 42443 (CO)
- Practice address
- 10240 Park Meadows Dr
Lone Tree, CO 80124-5425 - Phone
- (303) 338-4545
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070913000615 | CO | Practitioner - Otolaryngology | 1951495514 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45010 | AZ | MD | Otolaryngology Physician |
| 42443 | CO | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado Permanente Medical Group, P.C. | Otolaryngology | Current |
Accepting new patients |
| Northern Arizona Ear Nose and Throat PC | Otolaryngology | Past |
Accepting new patients |
| Valley ENT, PC | Otolaryngology | Past | Accepting new patients |
Locations
10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350
2045 N Franklin St
Denver, CO 80205
Phone (303) 764-4666
10240 Park Meadows Dr
Lone Tree, CO 80124
Phone (303) 649-5639
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 45010 | AZ | |
| Otolaryngology Physician | 207Y00000X | 42443 | CO | Yes |
Addresses
Primary practice location
10240 Park Meadows Dr
Lone Tree, CO 80124-5425
Mailing address
10350 E Dakota Ave
Denver, CO 80247-1314
Other practice location 1
2045 N Franklin St
Denver, CO 80205-5437
Phone (303) 338-4545
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015352 | Other | KAISER-COMMERCIAL NUMBER | |
| 59986841 | Medicaid | CO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Other providers in Lone Tree, CO
- Jeannine S Anderson
- Jessica Anderson
- Jessica L Anderson
- Loni B Anderson
- Mei Ling Anderson
- Nicole Cuesa Angelini
- Quentin Anson
- Krista Leigh Antenucci
- Jana Laura Antohe
- Apex Acupuncture and Wellness, LLC
All providers in Lone Tree, CO · Otolaryngology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.