Jessica Dawn Bradford, M.D.
Individual provider Active NPI Pediatrics Physician · Winchester, MA
NPI 1962414599 · NPPES record last updated Jun 10, 2015
Key facts
- NPI
- 1962414599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 262999 (MA)
- Practice address
- Winchester Hospital
41 Highland Avenue
Winchester, MA 01890 - Phone
- (617) 276-7066
- NPI assigned
- Aug 12, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Vanderbilt University School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kima-W Medical Center
Practice addresses (Care Compare)
535 Airport Rd
Hoopa, CA 95546-9615
Phone (530) 625-4261
Hospital & facility affiliations
- Mad River Community Hospital
- Providence St Joseph Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA, CA
- 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 |
|---|---|---|---|---|
| I20151113000907 | MA | Practitioner - Internal Medicine |
3779893185 | Reassigns benefits to 1 organization |
| I20260424001905 | CA | Practitioner - Internal Medicine |
3779893185 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manet Community Health Center, Inc. | Current |
Accepting new patients | |
| Manet Community Health Center, Inc. | Current |
Accepting new patients |
Locations
110 W Squantum St
Quincy, MA 02171
Phone (617) 376-3000
Interoperability endpoints
- https://api.platform.athenahealth.com/4368/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 262999 | MA | Yes |
| Internal Medicine Physician | 207R00000X | 262999 | MA |
Addresses
Primary practice location
Winchester Hospital
41 Highland Avenue
Winchester, MA 01890
Mailing address
Winchester Hospital
41 Highland Ave
Winchester, MA 01890
Phone (617) 276-7066
Other providers in Winchester, MA
- Robert Bordonaro
- Teresa Marie Bose
- Gordana Bosnic
- Christina Maria Bouboulis
- Corey Bova
- Eileen Bradley
- William L Breckwoldt III
- Bridge Consultants PLLC
- Bridge to Healing Psychotherapy LLC
- Patrick F Brophy
All providers in Winchester, MA · Pediatrics Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 10, 2015. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.