STEPHEN PETER BRADLEY MD NPI 1699746446

NPI Information

  • NPI: 1699746446
  • Provider Name: STEPHEN PETER BRADLEY, MD
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • CLIA Number: 05D0863464
  • Address: 5375 LAKESHORE BLVD
    LAKEPORT, CA
    ZIP 95453
  • Phone: (707) 263-5679

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NPI Details

Stephen Peter Bradley, MD is an addiction medicine family medicine in Lakeport, CA with 49 years of experience. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. Stephen Peter Bradley, MD NPI is 1699746446. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5375 LAKESHORE BLVD
LAKEPORT, CA
ZIP 95453-123
Phone: (707) 263-5679
Fax: (707) 263-7781

The NPI 1699746446 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D0863464 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Testing for presence of drug, read by direct observation (HCPCS:80305)
  • Smoking and tobacco use intensive counseling, 4-10 minutes (HCPCS:99406)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Smoking and tobacco use intensive counseling, more than 10 minutes (HCPCS:99407)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 1/30/2006 and was last updated on 9/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryC41489CALIFORNIANo
2208D00000XGeneral PracticeC41489CALIFORNIANo
3207QA0401XFamily MedicineAddiction MedicineC41489CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100C414890MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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