BRADLEY S MAZICK (PHD,HSPP) – Clinical Psychologist, NPI 1518933779

BRADLEY S MAZICK (PHD,HSPP) is a healthcare provider. based in South bend, Indiana. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD,HSPP. They hold a License No. 20041080 (IN). The NPI Number for BRADLEY S MAZICK (PHD,HSPP) is 1518933779

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
BRADLEY S MAZICK (PHD,HSPP)
NPI
1518933779
Phone
(574) 231-8000
Address
1920 RIDGEDALE RD
Enumeration Date
27 February 2006
Last Update Date
22 July 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5742318000
Graduation Year
1990 (36 years ago)
PAC ID
4789764184
Group Practice PAC ID
0648644641
Professional Enrollment ID
I20230314000221
Address ID
IN466172817SO912XXAVEX400
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

450 CLINICAL PSYCHOLOGIST in IN

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Provider Addresses for BRADLEY S MAZICK (PHD,HSPP)

  • 1920, Ridgedale Road, South Bend, Saint Joseph County, Indiana, 46614, United States

    SOUTH BEND, IN 466142243

    Phone: (574) 231-8000

    Fax: (574) 231-8013

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2023-03-14

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
I20230314000221IClinical PsychologistINTBD

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 46614)

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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: 0648644641View full group profile
NameSpecialtyState
Nurse PractitionerKY
Clinical PsychologistKS

Reviews

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Frequently asked questions

Is BRADLEY S MAZICK (PHD,HSPP) listed with a National Provider Identifier?
Yes — BRADLEY S MAZICK (PHD,HSPP) has NPI 1518933779 on file in the registry.
Would BRADLEY S MAZICK (PHD,HSPP) appear as active to a payer?
You can treat BRADLEY S MAZICK (PHD,HSPP) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe BRADLEY S MAZICK (PHD,HSPP)'s focus?
For BRADLEY S MAZICK (PHD,HSPP), the primary taxonomy reads as Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for BRADLEY S MAZICK (PHD,HSPP)?
Travel planning: use South Bend, Indiana as the reference point for BRADLEY S MAZICK (PHD,HSPP), then confirm.
Does BRADLEY S MAZICK (PHD,HSPP) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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