MACKENZIE BREANNA BRADLEY – Speech-Language Pathologist, NPI 1972285351

MACKENZIE BREANNA BRADLEY is a healthcare provider. based in Tyler, Texas. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold a License No. 121426 (TX). The NPI Number for MACKENZIE BREANNA BRADLEY is 1972285351

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
MACKENZIE BREANNA BRADLEY
NPI
1972285351
Phone
(903) 871-5712
Address
7282 CROSSWATER STE 100
Enumeration Date
3 August 2023
Last Update Date
8 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9038715712
Graduation Year
2023 (3 years ago)
PAC ID
3476916818
Group Practice PAC ID
1052743788
Professional Enrollment ID
I20230831003753
Address ID
TX757030659TY7282XCROS201
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

635 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in TX

Provider Addresses for MACKENZIE BREANNA BRADLEY

  • 7282 CROSSWATER STE 100

    TYLER, TX 757030659

    Phone: (903) 871-5712

    Fax: (903) 309-1035

    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: 2023-08-31

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
I20230831003753IQualified Speech Language PathologistTXTBD

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
92507Treatment of speech, language, voice, communication, and/or hearing processing disorder28116$0
92526Treatment of swallowing and feeding disorder22215$0
View full utilization report →

Insurance plans in this area (ZIP 75703)

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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: 1052743788View full group profile
NameSpecialtyState
Qualified Speech Language PathologistTX
Qualified Speech Language PathologistTX
Qualified Speech Language PathologistTX
Qualified Speech Language PathologistTX

Reviews

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Frequently asked questions

Is there an official ID for MACKENZIE BREANNA BRADLEY in U.S. healthcare records?
The official identifier for MACKENZIE BREANNA BRADLEY is NPI 1972285351.
Is MACKENZIE BREANNA BRADLEY still an active registrant?
MACKENZIE BREANNA BRADLEY carries an active NPI according to the public dataset.
What expertise is attributed to MACKENZIE BREANNA BRADLEY?
MACKENZIE BREANNA BRADLEY's specialty line reads Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
Where in Texas is MACKENZIE BREANNA BRADLEY registered?
Use Tyler, Texas as the headline location for MACKENZIE BREANNA BRADLEY here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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