DR. BRADLEY S BASHAM (O.D.) – Optometrist, NPI 1477547628

DR. BRADLEY S BASHAM (O.D.) is a healthcare provider. based in Fort wayne, Indiana. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 18002201 (IN). The NPI Number for DR. BRADLEY S BASHAM (O.D.) is 1477547628

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. BRADLEY S BASHAM (O.D.)
NPI
1477547628
Phone
(260) 744-2273
Address
1515 E PAULDING RD
Enumeration Date
2 September 2005
Last Update Date
10 June 2015

Doctor Profile

Medical School Name
INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY
Secondary Phone
5742693828
Graduation Year
1985 (41 years ago)
PAC ID
2769520667
Group Practice PAC ID
2264858588
Professional Enrollment ID
I20100129000409
Address ID
IN465823909WA3301XEXTX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,126 OPTOMETRY in IN

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Provider Addresses for DR. BRADLEY S BASHAM (O.D.)

  • 1515, East Paulding Road, Westchester, Fort Wayne, Allen County, Indiana, 46816, United States

    FORT WAYNE, IN 468161252

    Phone: (260) 744-2273

    Fax: (260) 744-4555

    Mailing address matches the actual address.

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 $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-08-23 • Largest payer in this snapshot: Alcon Vision LLC ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Alcon Vision LLC$20
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: 2010-01-29

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
I20100129000409IOptometryINTBD

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
92004New patient complete exam of visual system1515$0
92134Imaging of retina1515$0
92014Established patient complete exam of visual system1414$0
99213Established patient office or other outpatient visit, 20-29 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 46816)

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Provider's Procedures

DR. BRADLEY S BASHAM (O.D.) performs procedures in OPTOMETRY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYIN92083Measurement of field of vision during daylight conditions9792

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: 2264858588View full group profile
NameSpecialtyState
O P T O M E T R YIN
O P T O M E T R YIN
O P T O M E T R YIN

Reviews

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Frequently asked questions

Is there an official ID for DR. BRADLEY S BASHAM (O.D.) in U.S. healthcare records?
The official identifier for DR. BRADLEY S BASHAM (O.D.) is NPI 1477547628.
Would DR. BRADLEY S BASHAM (O.D.) appear as active to a payer?
You can treat DR. BRADLEY S BASHAM (O.D.) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe DR. BRADLEY S BASHAM (O.D.)'s focus?
For DR. BRADLEY S BASHAM (O.D.), the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
Is DR. BRADLEY S BASHAM (O.D.) located near Fort Wayne?
DR. BRADLEY S BASHAM (O.D.) currently maps to Fort Wayne, Indiana in this extract.
Can I trust this NPI listing for DR. BRADLEY S BASHAM (O.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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