Bradley Ingrao, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

LD61130137 Issued in WA

Practice address

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600

Phone

(702) 653-2273

NPI assigned

Jul 13, 2009

Last updated

Nov 8, 2022By 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 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gila River Health Care Corporation

  dba Komatke Health Center

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment NPD
• Gila River Health Care

  dba Thwajik Ke Outpatient Behavioral Health Services

  • Community/Behavioral Health Agency
  • Laveen, AZ
  • NPI 1598021495
  NPD
• Gila River Health Care Corporation

  dba Hu Hu Kam Memorial Hospital

  • Critical Access Hospital
  • Sacaton, AZ
  • NPI 1225023179
  NPD
• Gila River Health Care Corporation

  dba AK-Chin Clinic

  • Rural Acute Care Hospital
  • Maricopa, AZ
  • NPI 1386633915
  NPD
• Southern Ute Indian Tribe

  • Federally Qualified Health Center (FQHC)
  • Ignacio, CO
  • NPI 1407883309
  NPD (past)

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1932338985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAO",
        "first_name": "BRADLEY",
        "name_prefix": "Mr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD61130137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AUDIOLOGY LICENSE",
            "identifier": "AY1668",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• I-Stat Providers
• Javier J Ibarra, DPT
• Andrew Paul Ingel, DMD
• Kevin B Ingram, PSY D
• Victor Shawn Ingram, LCSW
• Brannon L Inman, MD
• Christina Irby, RN, CRNP
• Benjamin M Irmen, PHARMD
• Margaret Ann Ives
• Dylan Scott Jacobsen, DO

• Audiologist in Nellis AFB, NV
• Providers in Nellis AFB, NV by specialty
• Audiologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.