Dr Bradley Phillips, is a medicare enrolled "General Practice" physician in Mountain Home Afb, Idaho. His current practice location is
90 Hope Dr Bldg 6000, Mountain Home Afb, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 828-7362.
Dr Bradley Phillips is licensed to practice in Idaho (license number M-17656) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1245798180.
Physician's Profile
| Full Name | Dr Bradley Phillips |
|---|
| Gender | Male |
|---|
| Speciality | General Practice |
|---|
| Location | 90 Hope Dr Bldg 6000, Mountain Home Afb, Idaho |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1245798180
- Provider Enumeration Date: 03/11/2019
- Last Update Date: 05/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 6901248004
- Enrollment ID: I20240521001915
Medical Identifiers
Medical identifiers for Dr Bradley Phillips such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245798180 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | 0101270994 (Virginia) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | M-17656 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Bradley Phillips allows following entities to bill medicare on his behalf.
| Entity Name | St Lukes Clinic-treasure Valley Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1326336058
PECOS PAC ID: 4981878402
Enrollment ID: O20111119000045 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Bradley Phillips is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Bradley Phillips,
90 Hope Dr,
Mountain Home Afb, ID 83648-1057
Ph: (208) 828-7362 | Dr Bradley Phillips,
90 Hope Dr Bldg 6000,
Mountain Home Afb, ID 83648-1062
Ph: (208) 828-7362 |
Reviews and Comments