Bradley Wilson, in Loma Linda, CA - Medicare Nurse Practitioner

Bradley Wilson, is a medicare enrolled "Nurse Practitioner" in Loma Linda, California. His current practice location is 11262 Campus St, Loma Linda, California. You can reach out to his office (for appointments etc.) via phone at (909) 558-1000.

Bradley Wilson is licensed to practice in California (license number 95026798) 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 1447993530.

Contact Information

	Bradley Wilson,
	11262 Campus St, Loma Linda, CA 92350-1727
	(909) 558-1000
	Not Available

Map and Direction

Provider's Profile

Full Name	Bradley Wilson
Gender	Male
Speciality	Nurse Practitioner
Location	11262 Campus St, Loma Linda, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1447993530
Provider Enumeration Date: 04/16/2022
Last Update Date: 04/01/2024

Medicare PECOS Information:

PECOS PAC ID: 5890237176
Enrollment ID: I20240603002614

Medical Identifiers

Medical identifiers for Bradley Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1447993530	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	95026798 (California)	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. Bradley Wilson allows following entities to bill medicare on his behalf.

Entity Name	Vituity Physician Services Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1124884176 PECOS PAC ID: 0749620888 Enrollment ID: O20240506004038

Entity Name	Vituity Healthcare Services Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1700642758 PECOS PAC ID: 2668812710 Enrollment ID: O20240506004466

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. Bradley Wilson 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
Bradley Wilson, 11262 Campus St, Loma Linda, CA 92350-1727 Ph: (909) 558-1000	Bradley Wilson, 11262 Campus St, Loma Linda, CA 92350-1727 Ph: (909) 558-1000

Reviews and Comments

Nurse Practitioner Nurses in Loma Linda, CA

Holly Cornejo, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11201 Benton St, Loma Linda, CA 92357 Phone: 909-825-7084
Mrs. Kenya Neoko Singleton, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11201 Benton Street, Loma Linda, CA 92357 Phone: 909-825-7084 Fax: 909-777-3874
Miss Christine Eunice Kurunathan, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11034 Veach St, Loma Linda, CA 92354 Phone: 909-825-7084 Fax: 909-777-3291
Krista Smith, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11201 Benton St, Loma Linda, CA 92357 Phone: 909-825-7084
Cecille Bernad Ubbaonu, MSN, RN, AG-ACNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 11285 Mountain View Ave, 40, Loma Linda, CA 92354 Phone: 909-558-5844 Fax: 909-558-7873
Kristina Pulliam Markey, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11234 Anderson Strreet, Loma Linda, CA 92354 Phone: 909-558-5967
Lauren Trajano, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11234 Anderson St, Loma Linda, CA 92354 Phone: 909-558-8000

Bradley Wilson, - Medicare Nurse Practitioner in Loma Linda, CA