BRADLEY DAVIS JACK KLEINERT (PA-C) – Medical Physician Assistant, NPI 1629772231

BRADLEY DAVIS JACK KLEINERT (PA-C) is a healthcare provider. based in Coral springs, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 9117215 (FL). The NPI Number for BRADLEY DAVIS JACK KLEINERT (PA-C) is 1629772231

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
BRADLEY DAVIS JACK KLEINERT (PA-C)
NPI
1629772231
Phone
Not provided
Address
1591 NW 102ND WAY
Enumeration Date
28 March 2023
Last Update Date
28 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9544736600
Graduation Year
2022 (4 years ago)
PAC ID
4789049230
Group Practice PAC ID
7517850274
Professional Enrollment ID
I20230505000605
Address ID
FL333242701PL8201XBLVD405
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for BRADLEY DAVIS JACK KLEINERT (PA-C)

  • 1591 NW 102ND WAY

    CORAL SPRINGS, FL 330713916

    Phone:

    Type: Mailing

  • 8200 W SUNRISE BLVD BLDG C

    PLANTATION, FL 333225426

    Phone: (954) 370-8585

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 326 Open Payments records for all available years, with a total value of $6,409.

Total Amount is formed as General ($6,409) + Research ($0) + Ownership ($0) = $6,409.

Last reported payment date: 2024-12-30 • Largest payer in this snapshot: PFIZER INC. ($609).

Total Amount

$6,409

General + Research + Ownership

Payments

326

Total payment records

General Amount

$6,409

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-05-05

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
I20230505000605IPhysician AssistantFLTBD

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 33071)

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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: 7517850274View full group profile
NameSpecialtyState
H E M A T O L O G Y/ O N C O L O G YFL
Nurse PractitionerFL
H E M A T O L O G Y/ O N C O L O G YFL
H E M A T O L O G Y/ O N C O L O G YMI
H E M A T O L O G Y/ O N C O L O G YFL
H E M A T O L O G Y/ O N C O L O G YFL
Nurse PractitionerFL
H E M A T O L O G Y/ O N C O L O G YFL
Physician AssistantFL

Reviews

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Frequently asked questions

Does BRADLEY DAVIS JACK KLEINERT (PA-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — BRADLEY DAVIS JACK KLEINERT (PA-C) uses 1629772231.
Can I rely on BRADLEY DAVIS JACK KLEINERT (PA-C) being an active provider?
As of the registry snapshot, BRADLEY DAVIS JACK KLEINERT (PA-C) is marked active.
What is BRADLEY DAVIS JACK KLEINERT (PA-C)'s primary classification?
Medical Physician Assistant is the headline specialty for BRADLEY DAVIS JACK KLEINERT (PA-C) here. Clinical services aligned with this taxonomy classification.
What address line appears for BRADLEY DAVIS JACK KLEINERT (PA-C)?
BRADLEY DAVIS JACK KLEINERT (PA-C)'s geographic hint is Coral Springs, Florida in our summary view.
Is the information about BRADLEY DAVIS JACK KLEINERT (PA-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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