Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1235862012 Individual Practitioner Male Practitioner

Ryan Bradley , PA-C, CAQ-PSY

Physician Assistant - Medical • Eglin, FL

Professional Overview & Biography Verified Profile Summary

Ryan Bradley, PA-C, CAQ-PSY is a registered healthcare professional specializing in Physician Assistant - Medical in Eglin, FL. Practice services are available at 4315 EL SALVADOR WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4315 El Salvador Way

Eglin, FL 325421711

Telephone 5753866585
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant - Medical in Eglin, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.5 Yrs
Regional Practice Density
1 Specialists

Practicing in Eglin, FL (2836 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-04
Physician Assistant - Medical Primary Specialty

NUCC Taxonomy Code: 363AM0700X

State License FL 9118992

Definition to come...

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License TX 1198847

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID State Drivers License
B224-972-93-800-0 (FL)

Secondary Practice Locations

6600 Van Aalst Blvd

Fort Moore, GA 319052102

Phone: 9157422273

1 11th Ave Ste A2

Shalimar, FL 325791318

Phone: 8507909621

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

13 Historical Events
📍
Updated Practice Location October 04, 2024

Registered at 4315 EL SALVADOR WAY, EGLIN, FL 325421711 (Tel: 5753866585)

👤
Provider Name / Credentials Updated October 04, 2024

Recorded as RYAN BRADLEY, PA-C, CAQ-PSY

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 04, 2024

Physician Assistant (License #9118992 in FL)

📍
Updated Practice Location July 18, 2024

Registered at 6600 VAN AALST BLVD, FORT MOORE, GA 319052102 (Tel: 9157422273)

📍
Updated Business Mailing Address July 18, 2024

Registered at 6600 VAN AALST BLVD, FORT MOORE, GA 319052102 (Tel: 9157422273)

📍
Updated Practice Location August 14, 2022

Registered at 6028 SURETY DR, EL PASO, TX 799052018 (Tel: 9155443500)

📍
Updated Business Mailing Address August 14, 2022

Registered at 6028 SURETY DR, EL PASO, TX 799052018 (Tel: 5753866585)

NPI Profile Active July 07, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location July 07, 2022

Registered at 12616 ARROW WEED DR, EL PASO, TX 799286234 (Tel: 5753866585)

📍
Updated Business Mailing Address July 07, 2022

Registered at 12616 ARROW WEED DR, EL PASO, TX 799286234 (Tel: 5753866585)

👤
Provider Name / Credentials Updated July 07, 2022

Recorded as RYAN BRADLEY, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 07, 2022

Physician Assistant (License #1198847 in TX)

🟢
Initial NPI Registration & Enumeration July 07, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1235862012
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 07, 2022
Last Update: October 04, 2024
Sole Proprietor: No

Mailing Address

6600 Van Aalst Blvd

Fort Moore, GA 319052102

Phone: 9157422273

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.