Individual provider Active NPI

Bryan Edward Caudle, MD

  • Family Medicine Physician
  • Paradise, CA
National Provider Identifier
1992196349
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A165469 Issued in CA
Practice address
5125 Skyway
Paradise, CA 95969-5624
Phone
(530) 872-2000
NPI assigned
Feb 6, 2015
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A165469 CA Primary

Addresses

Primary practice location

5125 Skyway
Paradise, CA 95969-5624

Mailing address

5125 Skyway
Paradise, CA 95969-5624
Phone (530) 872-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210811003670 CA Practitioner - Family Practice 3173927266 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5125 Skyway
Paradise, CA 95969-5624
Phone (530) 872-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.74 of 100Reported as group
Quality
94
Promoting interoperability
92
Improvement activities
40
Cost
65.12

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A165469CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Clearlake Hospital Inc. CurrentSince Jun 1, 2025 Accepting new patients
Adventist Health Physicians Network CurrentSince Aug 1, 2021 Accepting new patients
Adventist Health Physicians Network Family Medicine CurrentSince Aug 1, 2021 Accepting new patients
Adventist Health Clearlake Hospital, Inc Past Accepting new patients

Locations

111 Raley Blvd
Ste 140
Chico, CA 95928
Phone (530) 342-5776

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

5125 Skyway
Paradise, CA 95969
Phone (530) 872-2000

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1992196349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 SKYWAY",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959695624",
            "telephone_number": "530-872-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 SKYWAY",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959695624",
            "telephone_number": "530-872-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDLE",
        "first_name": "BRYAN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-06",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A165469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paradise, CA

Sources for this page

Verify at the official NPI Registry.