MR. DEMETRIOS THOMAS BRADDOCK (MD) – Anatomic Pathology Physician, NPI 1720069024
Anatomic Pathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
323 PATHOLOGY in CT
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Provider Addresses for MR. DEMETRIOS THOMAS BRADDOCK (MD)
800, Howard Avenue, New Haven, New Haven County, Connecticut, 06519, United States
YALE PHYSICIANS BLDG
NEW HAVEN, CT 065191369
Phone: (203) 785-2140
Fax: (203) 785-6414
Type: Location
9805, Northwest Ash Street, West Haven, Portland, Metro, Washington County, Oregon, 97229, United States
300 GEORGE ST 6TH FLOOR
NEW HAVEN, CT 065360805
Phone: (203) 785-7998
Fax: (203) 785-6414
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-12-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040621000763 | I | Pathology | CT | TBD |
| I20201207002166 | I | Pathology | TN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88185 | Flow cytometry technique for dna or cell analysis, each additional marker | 5,067 | 216 | $0 |
| 88184 | Flow cytometry technique for dna or cell analysis, first marker | 222 | 215 | $0 |
| 88189 | Flow cytometry technique for dna or cell analysis, 16 or more markers | 210 | 204 | $0 |
| 88374 | Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure | 206 | 71 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 119 | 35 | $0 |
Insurance plans in this area (ZIP 06519)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PATHOLOGY | CT | 88342 | Tissue or cell analysis by immunologic technique | 91 | 78 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TN | |
| Nurse Practitioner | TN | |
| - | CO | |
| Physician Assistant | TN | |
| - | TN | |
| Nurse Practitioner | CA | |
| - | TN | |
| Internal Medicine | TN | |
| Internal Medicine | GA | |
| Radiation Oncology | TN |
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