CALI J BRADBERRY (PA-C) – Medical Physician Assistant, NPI 1831473198
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,534 PHYSICIAN ASSISTANT in ID
Provider Addresses for CALI J BRADBERRY (PA-C)
4750 N FIVE MILE RD
BOISE, ID 837132715
Phone: (208) 375-0500
Fax: (208) 375-4310
Type: Mailing
5985 W STATE ST
BOISE, ID 837033039
Phone: (208) 853-0071
Fax: (208) 853-9422
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 214 Open Payments records for all available years, with a total value of $3,374.
Total Amount is formed as General ($3,374) + Research ($0) + Ownership ($0) = $3,374.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($464).
Total Amount
$3,374
General + Research + Ownership
Payments
214
Total payment records
General Amount
$3,374
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2012-01-05
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120105000604 | I | Physician Assistant | ID | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 132 | 54 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 51 | 34 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 14 | 14 | $0 |
Insurance plans in this area (ZIP 83713)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | ID | 90792 | Psychiatric diagnostic evaluation with medical services | 20 | 20 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | ID | |
| - | ID | |
| - | ID | |
| Physician Assistant | ID | |
| Physician Assistant | ID | |
| Physician Assistant | ID | |
| Nurse Practitioner | ID | |
| - | ID | |
| - | ID | |
| Nurse Practitioner | ID |
Reviews
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