BRADLEY EVANSON – Dermatology Physician, NPI 1689069312

BRADLEY EVANSON is a healthcare provider. based in Dallas, Texas. specializing in DERMATOLOGY. They hold a License No. S1396 (TX). The NPI Number for BRADLEY EVANSON is 1689069312

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
BRADLEY EVANSON
NPI
1689069312
Phone
(254) 724-8800
Address
PO BOX 844658
Enumeration Date
31 March 2015
Last Update Date
27 September 2022

Doctor Profile

Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Secondary Phone
4356282826
Graduation Year
2015 (11 years ago)
PAC ID
5698096931
Group Practice PAC ID
4587675004
Professional Enrollment ID
I20220726002761
Address ID
UT847703620ST383XX300X300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:11State licenses:2Digital endpointsOther names

1,284 DERMATOLOGY in TX

Provider Addresses for BRADLEY EVANSON

  • PO BOX 844658

    DALLAS, TX 752844658

    Phone: (254) 724-8800

    Type: Mailing

  • 2401 S 31ST ST BLDG 27

    TEMPLE, TX 765081261

    Phone: (254) 724-6477

    Type: Location

  • 383 S 300 E

    ST GEORGE, UT 847703620

    Phone: (435) 628-2826

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 70 Open Payments records for all available years, with a total value of $1,209.

Total Amount is formed as General ($1,209) + Research ($0) + Ownership ($0) = $1,209.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($563).

Total Amount

$1,209

General + Research + Ownership

Payments

70

Total payment records

General Amount

$1,209

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2022-08-25

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220726002761IDermatologyUTTBD
I20220825004186IDermatologyNVTBD

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
17003Destruction of precancer skin growth, 2-14 growths3,662607$0
99213Established patient office or other outpatient visit, 20-29 minutes1,201970$0
17000Destruction of precancer skin growth, 1 growth824711$0
88305Pathology examination of tissue using a microscope, intermediate complexity675452$0
11102Biopsy of related skin growth, first growth368357$0
View full utilization report →

Insurance plans in this area (ZIP 75284)

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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: 4587675004View full group profile
NameSpecialtyState
Physician AssistantNV
-UT
Physician AssistantUT
Physician AssistantUT
D E R M A T O L O G YUT
Physician AssistantUT
D E R M A T O L O G YUT
Physician AssistantUT

Reviews

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Frequently asked questions

What number should I use to identify BRADLEY EVANSON for billing?
Administrative and clinical systems typically use NPI 1689069312 for BRADLEY EVANSON.
Should I treat BRADLEY EVANSON as an active provider?
Patients and plans typically see BRADLEY EVANSON as active in the national extract.
How should patients interpret BRADLEY EVANSON's specialty?
The extract shows Dermatology Physician for BRADLEY EVANSON. Clinical services aligned with this taxonomy classification.
What geographic area is tied to BRADLEY EVANSON?
BRADLEY EVANSON is associated with Dallas, Texas in the same public data insurers reference.
Who maintains BRADLEY EVANSON's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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