CMS-1500 Box 24J / 33a • NPI
1609289354
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207P00000X (CMS 93)
Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)
Box 32 Service Location & ZIP+4
55 LAKE AVE N, WORCESTER, MA, 01655-0002
✓ 9-Digit EDI 837 ZIP+4 (01655-0002)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1609289354 (EVAN S. BRADLEY, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1609289354)
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 11 |
99283 | Emergency department visit with low level of medical decision making | 18 |
99284 | Emergency department visit with moderate level of medical decision making | 42 |
99285 | Emergency department visit with high level of medical decision making | 65 |
99291 | Critical care, first 30-74 minutes | 22 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1609289354 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | EVAN S. BRADLEY, M.D. |
| Plain-English Specialty | Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: 207P00000X (Emergency Medicine) |
| Certifying / Licensing Body | American Board of Emergency Medicine (ABEM) |
| Practice Location Address | 55 LAKE AVE N, WORCESTER, MA, 01655-0002 |
| Practice Telephone / Fax | Tel: (508) 421-1400 | Fax: (508) 421-1490 |
| Administrative Mailing Address | PO BOX 415348, BOSTON, MA, 02241-5348 |
| Enumeration & Last Sync | Enumerated: 2014-06-10 | CMS Record Updated: 2020-11-09 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207P00000X)
What Does Taxonomy Code 207P00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207P00000X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (EVAN S. BRADLEY, M.D.)
Typical CPT / Diagnostic Procedures:- Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
- Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
- Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting
- Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
- Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
- Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207PT0002X — Emergency Medicine, Medical ToxicologyPlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: MA | License: 269735 | Primary: Secondary |
207P00000X — Emergency MedicinePlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: MA | License: 269735 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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