Brian R Bradshaw, MD - Medicare Dermatology in Provo, UT

Brian R Bradshaw, MD is a medicare enrolled "Dermatology" physician in Provo, Utah. He went to University Of Utah School Of Medicine and graduated in 1988 and has 36 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Central Utah Clinic Pc and his current practice location is 1055 N 500 W, Suite 111, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 374-8999.

Brian R Bradshaw is licensed to practice in Utah (license number 2806031205) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1811955800.

Contact Information

Brian R Bradshaw, MD
1055 N 500 W, Suite 111,
Provo, UT 84604-3305
(801) 374-8999
(801) 429-8063



Physician's Profile

Full NameBrian R Bradshaw
GenderMale
SpecialityDermatology
Experience36 Years
Location1055 N 500 W, Provo, Utah
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Brian R Bradshaw attended and graduated from University Of Utah School Of Medicine in 1988
  NPI Data:
  • NPI Number: 1811955800
  • Provider Enumeration Date: 05/02/2006
  • Last Update Date: 11/27/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 6002862935
  • Enrollment ID: I20050323001451

Medical Identifiers

Medical identifiers for Brian R Bradshaw such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1811955800NPI-NPPES
03-00064OtherUTUNITED HEALTHCARE
36578OtherUTPEHP
QM0000001619OtherUTALTIUS
225984OtherUTDMBA
107006919101OtherUTIHC HEALTHPLANS
070008058OtherUTPALMETTO

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207N00000XDermatology 2806031205 (Utah)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Central Utah Clinic Pc7517868508391

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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. Brian R Bradshaw allows following entities to bill medicare on his behalf.
Entity NameCentral Utah Clinic Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093764805
PECOS PAC ID: 7517868508
Enrollment ID: O20040113000805

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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. Brian R Bradshaw 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 AddressPractice Location Address
Brian R Bradshaw, MD
1055 N 500 W, Attn: Credentialing,
Provo, UT 84604-3305

Ph: (801) 354-8225
Brian R Bradshaw, MD
1055 N 500 W, Suite 111,
Provo, UT 84604-3305

Ph: (801) 374-8999

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Dermatology Doctors in Provo, UT

Dr. Payam Tristani-firouzi, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1055 N 500 W Ste 111, Provo, UT 84604
Phone: 801-374-8999    Fax: 801-429-8063
Dr. Richard L Stone, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1275 N University Ave Ste 23, Provo, UT 84604
Phone: 801-377-4745    Fax: 801-373-5762
Jake Fagan, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1055 N 500 W # 111, Provo, UT 84604
Phone: 801-374-8999    
Garrett C Lowe, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 3200 N Canyon Rd Ste D, Provo, UT 84604
Phone: 801-373-3300    Fax: 801-354-7900
Mr. Gregory J Wing, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1055 N 500 W Ste 111, Provo, UT 84604
Phone: 801-354-8225    Fax: 801-418-0941
Margaret Hammond,
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 395 W Cougar Blvd Ste 604, Provo, UT 84604
Phone: 801-357-0613    

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