Individual provider Active NPI

Bradley Arden Radwaner, M.D

  • Cardiovascular Disease Physician
  • New York, NY
National Provider Identifier
1992893127
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
150577 Issued in NY
Practice address
136 E. 57TH St.
Suite 1001
New York, NY 10022
Phone
(212) 717-0666
Fax
(212) 717-2399
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 150577 NY Primary

Addresses

Primary practice location

136 E. 57TH St.
Suite 1001
New York, NY 10022

Mailing address

136 E. 57TH St.
Suite 1001
New York, NY 10022
Phone (212) 717-0666

Other identifiers 2

IdentifierTypeStateIssuer
BR078A9110OtherNYBCBS
00896117MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080519000328 NY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7810066701 Reassigns benefits to 2 organizations
I20210930000435 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7810066701

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1980
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
360 Complete Medical PCGroup PAC ID 5496299091, 3 clinicians

Practice addresses (Care Compare)

120 E 56TH St
FL 14
New York, NY 10022-3699
Phone (212) 348-5100

136 E 57TH St
Suite 1001
New York, NY 10022-2963
Phone (212) 717-0666

Hospital & facility affiliations

  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
360 Complete Medical PC CurrentSince May 28, 2024 Accepting new patients
Cardiovascular Imaging of Brooklyn, PC Cardiovascular Disease Past Accepting new patients
Yadegar Medical P.C. PastSince Jan 6, 2016 Accepting new patients
Nuclear Cardiac and Medical Imaging Services, PC Cardiovascular Disease Past Accepting new patients

Locations

120 E 56th St
Fl 14
New York, NY 10022
Phone (212) 348-5100

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: bradwaner64579@northwell.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FECBAA/Endpoint/FECBAA

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1992893127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E. 57TH ST.",
            "address_2": "SUITE 1001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-717-0666",
            "fax_number": "212-717-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E. 57TH ST.",
            "address_2": "SUITE 1001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "212-717-0666",
            "fax_number": "212-717-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADWANER",
        "first_name": "BRADLEY",
        "middle_name": "ARDEN",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "150577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "BR078A9110",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00896117",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.