Individual provider Active NPI

Bradford Gregory Ledzian, PA-C

  • Surgical Physician Assistant
  • Orlando, FL
National Provider Identifier
1952376907
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9107190 Issued in FL
Practice address
2415 N Orange Ave Ste 700
Orlando, FL 32804-5521
Phone
(407) 303-2474
Fax
(407) 303-0680
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001228 CT
Physician Assistant 363A00000X 25MP00085600 NJ
Surgical Physician Assistant 363AS0400X PA9107190 FL Primary

Addresses

Primary practice location

2415 N Orange Ave Ste 700
Orlando, FL 32804-5521

Mailing address

2415 N Orange Ave Ste 700
Orlando, FL 32804-5521
Phone (407) 303-2474

Other practice location 1

2415 N Orange Ave
Suite 600
Orlando, FL 32804-5505
Phone (407) 303-5600

Other identifiers 1

IdentifierTypeStateIssuer
HI023ZOtherFLPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130710000234 FL Practitioner - Physician Assistant 8921278045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00085600NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System Sunbelt Inc CurrentSince May 28, 2013 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Feb 28, 2017 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Feb 28, 2017 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

2415 N Orange Ave
Ste 700
Orlando, FL 32804
Phone (407) 303-2474

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: bledzian73430@adventhealth.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1952376907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 700",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045521",
            "telephone_number": "407-303-2474",
            "fax_number": "407-303-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 N ORANGE AVE STE 700",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045521",
            "telephone_number": "407-303-2474",
            "fax_number": "407-303-0680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2415 N Orange Ave",
            "address_2": "Suite 600",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328045505",
            "country_code": "US",
            "telephone_number": "407-303-5600",
            "fax_number": "407-303-0678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDZIAN",
        "first_name": "BRADFORD",
        "middle_name": "GREGORY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "001228",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00085600",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9107190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "HI023Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.