BRADLEY DEAN BOSTIC (CNP) – Adult Health Nurse Practitioner, NPI 1467729202

BRADLEY DEAN BOSTIC (CNP) is a healthcare provider. based in Mansfield, Ohio. specializing in Adult Health Nurse Practitioner. They hold the professional credentials CNP. They hold a License No. 359240 (OH). The NPI Number for BRADLEY DEAN BOSTIC (CNP) is 1467729202

Main info

Male
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
BRADLEY DEAN BOSTIC (CNP)
NPI
1467729202
Phone
(419) 685-3369
Address
626 LEXINGTON ONTARIO RD
Enumeration Date
22 November 2011
Last Update Date
21 November 2016

Doctor Profile

Medical School Name
CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Secondary Phone
4192817107
Graduation Year
2012 (14 years ago)
PAC ID
4385807536
Group Practice PAC ID
5496756074
Professional Enrollment ID
I20120525000162
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

Provider Addresses for BRADLEY DEAN BOSTIC (CNP)

  • 626 LEXINGTON ONTARIO RD

    MANSFIELD, OH 449037563

    Phone: (419) 685-3369

    Type: Mailing

  • 1050 DAUCH DR

    ASHLAND, OH 448058845

    Phone: (419) 685-3369

    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: 2012-05-25

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
I20120525000162INurse PractitionerOHTBD

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
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes8931$0
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes4617$0
View full utilization report →

Insurance plans in this area (ZIP 44903)

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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: 5496756074View full group profile
NameSpecialtyState
Nurse PractitionerOH

Reviews

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Frequently asked questions

Can I cross-check BRADLEY DEAN BOSTIC (CNP) using NPI 1467729202?
NPI 1467729202 belongs to BRADLEY DEAN BOSTIC (CNP); compare other details if you need extra assurance.
Is there an active status for BRADLEY DEAN BOSTIC (CNP)?
For scheduling context, BRADLEY DEAN BOSTIC (CNP) is shown as active in the registry.
What area of care is associated with BRADLEY DEAN BOSTIC (CNP)?
BRADLEY DEAN BOSTIC (CNP)'s record emphasizes Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with BRADLEY DEAN BOSTIC (CNP)?
Directory geography for BRADLEY DEAN BOSTIC (CNP) centers on Mansfield, Ohio.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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