ANGIE S BRADLEY (PA-C) – Surgical Physician Assistant, NPI 1811322340

ANGIE S BRADLEY (PA-C) is a healthcare provider. based in Marietta, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 006885 (GA). The NPI Number for ANGIE S BRADLEY (PA-C) is 1811322340

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
ANGIE S BRADLEY (PA-C)
NPI
1811322340
Phone
(770) 427-5717
Address
300 TOWER ROAD
Enumeration Date
3 September 2013
Last Update Date
31 January 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7704269945
Graduation Year
2012 (14 years ago)
PAC ID
3476787342
Group Practice PAC ID
3577470442
Professional Enrollment ID
I20131008001089
Address ID
GA301444989KE390XXNWXX601
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

4,431 PHYSICIAN ASSISTANT in GA

Provider Addresses for ANGIE S BRADLEY (PA-C)

  • 300 TOWER ROAD

    SUITE 200

    MARIETTA, GA 300609403

    Phone: (770) 427-5717

    Fax: (770) 514-5040

    Type: Mailing

  • 1505 STONEBRIDGE PARKWAY

    SUITE 200

    WOODSTOCK, GA 30189

    Phone: (770) 926-9112

    Fax: (770) 926-8240

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $24.

Total Amount is formed as General ($24) + Research ($0) + Ownership ($0) = $24.

Last reported payment date: 2024-02-13 • Largest payer in this snapshot: Sanara MedTech Inc. ($24).

Total Amount

$24

General + Research + Ownership

Payments

1

Total payment records

General Amount

$24

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-02-13

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Sanara MedTech Inc.$24
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: 2013-10-08

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
I20131008001089IPhysician AssistantGATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
20610Aspiration and/or injection of fluid from large joint1816$0
99213Established patient office or other outpatient visit, 20-29 minutes1212$0
29827Repair of shoulder rotator cuff using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 30060)

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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: 3577470442View full group profile

Reviews

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Frequently asked questions

Is ANGIE S BRADLEY (PA-C) listed with a National Provider Identifier?
Yes — ANGIE S BRADLEY (PA-C) has NPI 1811322340 on file in the registry.
Is ANGIE S BRADLEY (PA-C) shown as active in public data?
Registry records indicate ANGIE S BRADLEY (PA-C) maintains an active NPI.
How would a patient describe ANGIE S BRADLEY (PA-C)'s focus?
For ANGIE S BRADLEY (PA-C), the primary taxonomy reads as Surgical Physician Assistant. Clinical services aligned with this taxonomy classification.
Is ANGIE S BRADLEY (PA-C) located near Marietta?
ANGIE S BRADLEY (PA-C) currently maps to Marietta, Georgia in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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