KATHLEEN BRADLEY-ANDERSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1104840966

KATHLEEN BRADLEY-ANDERSON (CRNA) is a healthcare provider. based in Mangonia park, Florida. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. APRN3210092 (FL). The NPI Number for KATHLEEN BRADLEY-ANDERSON (CRNA) is 1104840966

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN BRADLEY-ANDERSON (CRNA)
NPI
1104840966
Phone
(561) 844-6300
Address
901 45TH ST
Enumeration Date
26 July 2006
Last Update Date
21 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2396245000
Graduation Year
2005 (21 years ago)
PAC ID
4587674882
Group Practice PAC ID
0345143152
Professional Enrollment ID
I20060502000181
Address ID
FL341025754NA350XXNXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

5,359 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in FL

Provider Addresses for KATHLEEN BRADLEY-ANDERSON (CRNA)

  • 901 45TH ST

    MANGONIA PARK, FL 334072413

    Phone: (561) 844-6300

    Type: Mailing

  • Southwest 152nd Street, Palmetto Bay, Miami-Dade County, Florida, 33158, United States

    PALMETTO BAY, FL 331571778

    Phone: (305) 256-5267

    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: 2006-05-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060502000181ICertified Registered Nurse Anesthetist (Crna)FLTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33407)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345143152View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YFL
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)FL
-FL
A N E S T H E S I O L O G YFL
Certified Registered Nurse Anesthetist (Crna)FL
A N E S T H E S I O L O G YFL
A N E S T H E S I O L O G YFL
-FL
-FL

Reviews

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Frequently asked questions

What is the registry number for KATHLEEN BRADLEY-ANDERSON (CRNA)?
The registry entry for KATHLEEN BRADLEY-ANDERSON (CRNA) shows NPI 1104840966.
Should I treat KATHLEEN BRADLEY-ANDERSON (CRNA) as an active provider?
Patients and plans typically see KATHLEEN BRADLEY-ANDERSON (CRNA) as active in the national extract.
How should patients interpret KATHLEEN BRADLEY-ANDERSON (CRNA)'s specialty?
The extract shows Certified Registered Nurse Anesthetist for KATHLEEN BRADLEY-ANDERSON (CRNA). Clinical services aligned with this taxonomy classification.
What city is tied to KATHLEEN BRADLEY-ANDERSON (CRNA)?
The directory associates KATHLEEN BRADLEY-ANDERSON (CRNA) with Mangonia Park, Florida. Check all listed addresses for suites or satellite offices.
Can I export KATHLEEN BRADLEY-ANDERSON (CRNA)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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