Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124000518 Individual Practitioner Male Practitioner

Dr. John Andrew Bradshaw , MD

Pediatrics • Ithaca, NY

Professional Overview & Biography Verified Profile Summary

Dr. John Bradshaw, MD is a registered healthcare professional specializing in Pediatrics in Ithaca, NY. Practice services are available at 10 GRAHAM RD W under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

10 Graham Rd W

Ithaca, NY 148501055

Telephone 6072572188
Fax 6072667341
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Ithaca, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.1 Yrs
Regional Practice Density
16 Specialists

Practicing in Ithaca, NY (6127 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

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License NY 216716

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics - Pediatric Infectious Diseases

NUCC Taxonomy Code: 2080P0208X

State License NY 216716

A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
02223650 (NY)
Commercial Insurance / Payer ID Blue Shield/hmo/excellus
000136319
Commercial Insurance / Payer ID Totalcare/managed Ma
10867 (NY)
Commercial Insurance / Payer ID Tricare
V018315
Commercial Insurance / Payer ID Rmsco
161010811
Commercial Insurance / Payer ID Commercial Carriers
161010811
Commercial Insurance / Payer ID Health Now
00920290002

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

28 Associated Practitioners
Charlene Brew

Physician Assistant

NPI 1003524646
NPI 1124965538

Licensed Master Social Worker, Licensed Clinical Social Worker

Cecilia Tetzlaff , NP

Nurse Practitioner - Pediatrics

NPI 1215683420

Nurse Practitioner

NPI 1225443427

Doctor of Medicine (M.D.)

Jennifer Whittaker , FNP

Nurse Practitioner - Family

NPI 1245212968

Family Nurse Practitioner

Yulia Maggart , MSN, RN, APRN

Nurse Practitioner - Pediatrics

NPI 1285377598

Master of Science in Nursing, Registered Nurse, Advanced Practice Registered Nurse

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active September 21, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location September 21, 2012

Registered at 10 GRAHAM RD W, ITHACA, NY 148501055 (Tel: 6072572188)

📍
Updated Business Mailing Address September 21, 2012

Registered at 10 GRAHAM RD W, ITHACA, NY 148501055 (Tel: 6072572188)

👤
Provider Name / Credentials Updated September 21, 2012

Recorded as JOHN BRADSHAW, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 21, 2012

Pediatrics (License #216716 in NY)

🟢
Initial NPI Registration & Enumeration November 19, 2005

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: 1124000518
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 19, 2005
Last Update: September 21, 2012
Sole Proprietor: No

Mailing Address

10 Graham Rd W

Ithaca, NY 148501055

Phone: 6072572188

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.