JOHN EDWARD BRADFORD (PA-C) – Physician Assistant, NPI 1720004740
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
323 PHYSICIAN ASSISTANT in WY
Provider Addresses for JOHN EDWARD BRADFORD (PA-C)
PO BOX 7609
MISSOULA, MT 598077609
Phone: (406) 721-5600
Fax: (406) 721-3907
Type: Mailing
108 Albright Ave #58
YNP, WY 82190
Phone: (307) 344-7965
Type: Location
PO BOX 58
YELLOWSTONE NATIONAL PARK, WY 821900058
Phone: (307) 344-7965
Type: Mailing
701 TUDOR DR
STE 110
ANCHORAGE, AK 99503
Phone: (907) 685-1420
Type: Location
Saint Patrick Hospital, 500, West Broadway Street, Heart of Missoula, Missoula, Missoula County, Montana, 59802, United States
MISSOULA, MT 598024008
Phone: (406) 721-5600
Fax: (406) 721-3907
Type: Location
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: 2017-09-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20100916000553 | I | Physician Assistant | WY | TBD |
| I20170921002023 | I | Physician Assistant | MT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 59807)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | WY | |
| Physician Assistant | CO | |
| Physician Assistant | NY | |
| Nurse Practitioner | TX | |
| Emergency Medicine | CO | |
| Physician Assistant | CO | |
| Nurse Practitioner | MN | |
| Physician Assistant | TX | |
| Physician Assistant | WV | |
| Physician Assistant | WY |
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