BRADLEY G NEVINS (PHD) – Psychologist, NPI 1336248137

BRADLEY G NEVINS (PHD) is a healthcare provider. based in Saint croix falls, Wisconsin. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 1436-057 (WI). The NPI Number for BRADLEY G NEVINS (PHD) is 1336248137

Main info

Male
38 Years Of Experience
Name
BRADLEY G NEVINS (PHD)
NPI
1336248137
Phone
(715) 483-3221
Address
204 S ADAMS ST
Enumeration Date
21 September 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7158080795
Graduation Year
1988 (38 years ago)
PAC ID
9335116649
Group Practice PAC ID
9234155136
Professional Enrollment ID
I20040915001022
Address ID
WI540169230HU1334XSTXX301
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

667 CLINICAL PSYCHOLOGIST in WI

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Provider Addresses for BRADLEY G NEVINS (PHD)

  • 204, South Adams Street, St. Croix Falls, Polk County, Wisconsin, 54024, United States

    SAINT CROIX FALLS, WI 540249449

    Phone: (715) 483-3221

    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: 2004-09-15

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
I20040915001022IClinical PsychologistWITBD

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

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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 54024)

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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: 9234155136View full group profile
NameSpecialtyState
Mental Health CounselorWI
Mental Health CounselorWI

Reviews

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Frequently asked questions

Does BRADLEY G NEVINS (PHD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — BRADLEY G NEVINS (PHD) uses 1336248137.
Does the file indicate BRADLEY G NEVINS (PHD) is practicing under active NPI?
Directory data currently reports BRADLEY G NEVINS (PHD) as active.
What is BRADLEY G NEVINS (PHD)'s specialty?
The listing groups BRADLEY G NEVINS (PHD) with Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for BRADLEY G NEVINS (PHD)?
BRADLEY G NEVINS (PHD)'s geographic hint is Saint Croix Falls, Wisconsin in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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