BRADLEY JASON INGRAHAM (PA) – Physician Assistant, NPI 1659368116

BRADLEY JASON INGRAHAM (PA) is a healthcare provider. based in Mauston, Wisconsin. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 1073 (WI). The NPI Number for BRADLEY JASON INGRAHAM (PA) is 1659368116

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
BRADLEY JASON INGRAHAM (PA)
NPI
1659368116
Phone
Not provided
Address
1040 DIVISION ST
Enumeration Date
30 September 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6082548888
Graduation Year
1998 (28 years ago)
PAC ID
0648451492
Group Practice PAC ID
8527971399
Professional Enrollment ID
I20110225000879
Address ID
WI539658293WI28XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,678 PHYSICIAN ASSISTANT in WI

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Provider Addresses for BRADLEY JASON INGRAHAM (PA)

  • 1040, Division Street, Mauston, Juneau County, Wisconsin, 53948, United States

    MAUSTON, WI 539481931

    Phone:

    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)

CMS reports 4 Open Payments records for all available years, with a total value of $150.

Total Amount is formed as General ($150) + Research ($0) + Ownership ($0) = $150.

Last reported payment date: 2024-11-04 • Largest payer in this snapshot: ABIOMED ($150).

Total Amount

$150

General + Research + Ownership

Payments

4

Total payment records

General Amount

$150

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-04

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABIOMED$150
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: 2011-02-25

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
I20110225000879IPhysician AssistantWITBD

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 53948)

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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: 8527971399View full group profile
NameSpecialtyState
-WI
Physician AssistantWI
Certified Registered Nurse Anesthetist (Crna)WI
Orthopedic SurgeryWI
O B S T E T R I C S/ G Y N E C O L O G YWI
Nurse PractitionerWI
General SurgeryWI
-WI
Orthopedic SurgeryWI
Physician AssistantWI

Reviews

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Frequently asked questions

What federal number belongs to BRADLEY JASON INGRAHAM (PA)?
The federal identifier for BRADLEY JASON INGRAHAM (PA) is NPI 1659368116.
Is BRADLEY JASON INGRAHAM (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does BRADLEY JASON INGRAHAM (PA) work in?
You can think of BRADLEY JASON INGRAHAM (PA) as practicing within Physician Assistant. Clinical services aligned with this taxonomy classification.
What location shows for BRADLEY JASON INGRAHAM (PA)?
We surface Mauston, Wisconsin for BRADLEY JASON INGRAHAM (PA) based on available NPPES addresses.
How can I contact BRADLEY JASON INGRAHAM (PA)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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