BRADFORD J BROUILLETTE (PT) – Physical Therapist, NPI 1861589350

BRADFORD J BROUILLETTE (PT) is a healthcare provider. based in Walla walla, Washington. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT00008159 (WA). The NPI Number for BRADFORD J BROUILLETTE (PT) is 1861589350

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
BRADFORD J BROUILLETTE (PT)
NPI
1861589350
Phone
(509) 897-3320
Address
410 W POPLAR ST.
Enumeration Date
6 October 2006
Last Update Date
11 January 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5098973333
Graduation Year
1999 (27 years ago)
PAC ID
0042218828
Group Practice PAC ID
2860552973
Professional Enrollment ID
I20061110000404
Address ID
WA993622924WA380XXAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

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Provider Addresses for BRADFORD J BROUILLETTE (PT)

  • 410, West Poplar Street, Walla Walla, Walla Walla County, Washington, 99362, United States

    REHABILITATION SERVICES

    WALLA WALLA, WA 99362

    Phone: (509) 897-3320

    Fax: (509) 897-5752

    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: 2006-11-10

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
I20061110000404IPhysical Therapist In Private PracticeWATBD

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 99362)

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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: 2860552973View full group profile
NameSpecialtyState
Emergency MedicineCO
Hospitalist, Internal MedicineUT
Nurse PractitionerWA
Internal Medicine, HospitalistID
N E U R O L O G YOR
Family PracticeWA
-WA
Emergency MedicineWA
Physical Therapist In Private PracticeWA
Nurse PractitionerWA

Reviews

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Frequently asked questions

Does BRADFORD J BROUILLETTE (PT) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — BRADFORD J BROUILLETTE (PT) uses 1861589350.
Does CMS list BRADFORD J BROUILLETTE (PT) as active?
Yes — BRADFORD J BROUILLETTE (PT) is active in the NPI listing used on this page.
What is BRADFORD J BROUILLETTE (PT) best known for clinically?
Directory data describes BRADFORD J BROUILLETTE (PT) with Physical Therapist. Clinical services aligned with this taxonomy classification.
Where should I expect BRADFORD J BROUILLETTE (PT) on a map?
Expect Walla Walla, Washington as a primary anchor for BRADFORD J BROUILLETTE (PT) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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