DR. LAURENCE MARTIN JR. BRADLEY (M.D.) – Dermatology Physician, NPI 1639516313
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
703 DERMATOLOGY in IL
Provider Addresses for DR. LAURENCE MARTIN JR. BRADLEY (M.D.)
4909 N. GLEN PARK PLACE
PEORIA, IL 616144676
Phone: (309) 674-7546
Fax: (309) 282-2075
Type: Mailing
2230 HUNTINGTON DR N
ALGONQUIN, IL 601024419
Phone: (847) 603-4146
Fax: (847) 960-3675
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 119 Open Payments records for all available years, with a total value of $3,063.
Total Amount is formed as General ($3,063) + Research ($0) + Ownership ($0) = $3,063.
Last reported payment date: 2024-12-27 • Largest payer in this snapshot: Organogenesis Inc. ($929).
Total Amount
$3,063
General + Research + Ownership
Payments
119
Total payment records
General Amount
$3,063
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $929 |
| ABBVIE INC. | $795 |
| Sun Pharmaceutical Industries Inc. | $294 |
| Incyte Corporation | $179 |
| Lilly USA, LLC | $145 |
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: 2017-08-01
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 |
|---|---|---|---|---|
| I20170801002584 | I | Dermatology | IL | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 136 | 15 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 56 | 31 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 36 | 26 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 32 | 32 | $0 |
| 11311 | Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm | 22 | 15 | $0 |
Insurance plans in this area (ZIP 61614)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| Physician Assistant | IL | |
| Pathology, Dermatology, Dermatology, Pathology | IL | |
| D E R M A T O L O G Y | IL |
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