Mark S. Bradley, M.D. LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2002-0015 Issued in NM

Legal business name

MARK S. BRADLEY, M.D. LLC

Practice address

2015 Galisteo St
Santa Fe, NM 87505-2101

Phone

(505) 466-2575

Fax

(505) 989-1550

NPI assigned

May 13, 2009

Last updated

May 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark S Bradley, M.D.NPI 1497786867

Title

Owner/Physician

Phone

(505) 466-2575

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Stephen Bradley, MD

  • Ophthalmology Physician
  • Santa Fe, NM
  • NPI 1497786867
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1891929238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052101",
            "telephone_number": "505-466-2575",
            "fax_number": "505-989-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 GALISTEO ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052101",
            "telephone_number": "505-466-2575",
            "fax_number": "505-989-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK S. BRADLEY, M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-13",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "505-466-2575",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NM",
            "license": "2002-0015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn L Matthews MD
• Claudia Gabriela Marin-Villalobos
• Paulette Maria Marin
• Mary Ellen Marino, DOM,N.D.
• Mariposa Health & Beauty Spa
• Mark Seredowych, MD, PC
• Stephen David Markowitz, MD
• Judy Fay Marks, LISW
• Ashley Diane Markus
• Felicia Marohn, LCSW

• Ophthalmology Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Ophthalmology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.