MR. BRADLEY THOMAS DEWITT (NPI# 1346891900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346891900 |
| Entity Type | Individual |
| Full Name | MR. BRADLEY THOMAS DEWITT |
| Credential | PA-C |
| Practice Address |
1780 Hanshaw Rd Ithaca NY 14850-9105 |
| Mailing Address |
28 Glenside Dr Moravia NY 13118-3573 |
| Practice Telephone | 3152833608 |
| Mailing Telephone | 3152833608 |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-11-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 024437 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1780 HANSHAW RD |
| City | ITHACA |
| State | NY |
| Zip Code | 14850-9105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205839933 | Catherine Jean Cannariato | Family Medicine | 1780 Hanshaw Rd, Ithaca, NY 14850-9105 | 2005-05-27 |
| 1407418478 | Elizabeth D Nowalk | Nurse Practitioner | 1780 Hanshaw Rd, Ithaca, NY 14850-9105 | 2019-07-01 |
| 1720476922 | Debra Regnier | Occupational Therapist | 1780 Hanshaw Rd, Ithaca, NY 14850-9105 | 2014-12-23 |
| 1518385269 | Syed Jibran Shah | Family Medicine | 1780 Hanshaw Rd, Ithaca, NY 14850-9105 | 2014-03-31 |
| 1669808333 | Guthrie Speciality Physicians, PC | Durable Medical Equipment & Medical Supplies | 1780 Hanshaw Rd, Ithaca, NY 14850-9105 | 2013-09-25 |
| 1811242472 | Katie Erin Bowers | Physical Therapist | 1780 Hanshaw Rd, Ithaca, NY 14850-9105 | 2012-07-19 |
| 1063719110 | Tamara Arleen Reynolds | Dietitian, Registered | 1780 Hanshaw Rd, Ithaca, NY 14850 | 2011-02-24 |
| 1619273166 | Carrie M Hathaway | Occupational Therapist | 1780 Hanshaw Rd, Ithaca, NY 14850-9105 | 2011-02-01 |
| 1669708251 | Guthrie Clinic Ltd | Clinic/Center | 1780 Hanshaw Rd, Ithaca, NY 14850-9105 | 2009-11-02 |
| 1508010919 | Kathryne C Smith | Physical Therapist | 1780 Hanshaw Rd, Ithaca, NY 14850-9105 | 2008-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123897 | Michelle Lee Sanito | Registered Nurse | 400 Lake Street, Ithaca, NY 14850 | 2020-10-30 |
| 1457959843 | Summit Alternatives Lmsw PC | Community/Behavioral Health | 215 North Cayuga Street, 2nd Floor Business Complex, Ithaca, NY 14850 | 2020-10-16 |
| 1518581701 | Sameer Acharya | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency, Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-03 |
| 1699399873 | Anurag Aryal | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Internal Medicine Residency, Cayuga Med, Ithaca, NY 14850 | 2020-06-03 |
| 1932723228 | Binay Kumar Kshetree | Student in an Organized Health Care Education/Training Program | Cayuga Medical Center, 101 Dates Drive, Ithaca, NY 14850 | 2020-06-02 |
| 1225657349 | Nima Hazrati Pour Fard | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Cayuga Medical Center, 101, Ithaca, NY 14850 | 2020-04-09 |
| 1326671090 | Garret Hoskey | Specialist/Technologist | 953 Dany Road, Ithaca, NY 14850 | 2020-02-20 |
| 1609407709 | En-ting Hsu | Marriage & Family Therapist | 110 N. Cayuga Street 4th Floor Suite 3, Ithaca, NY 14850 | 2020-01-28 |
| 1306491063 | Patrick Owen Mckeon | Specialist/Technologist | Hill Center G66, 953 South Danby Rd., Ithaca, NY 14850 | 2019-08-08 |
| 1538722343 | Priyesh Thakurathi | Student in an Organized Health Care Education/Training Program | 101 Dates Drive Cayuga Medical Center, Internal Medicine Residency Program, Ithaca, NY 14850 | 2019-04-17 |
| Find all providers in zip 14850 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023647013 | Shanise Thomas | Physician Assistant | 108 Sapsucker Woods Rd Apt 2a, Ithaca, NY 14850-1979 | 2020-04-02 |
| 1861747388 | Tess Elizabeth Macqueen | Physician Assistant | 2333 N Triphammer Rd Ste 203, Ithaca, NY 14850 | 2012-07-20 |
| 1396078648 | Sarah Bodie Robinson | Physician Assistant | 16 Brentwood Dr Ste A, Ithaca, NY 14850-1863 | 2009-09-17 |
| 1144323049 | Thomas E Brown | Physician Assistant | 2333 N Triphammer Rd, Ithaca, Ny 14850, Derm Assc of Ithaca, Ithaca, NY 14850 | 2006-09-06 |
| 1073534590 | Julie J Higgins | Physician Assistant | 740 S Meadow St, Ithaca, NY 14850-5377 | 2006-07-21 |
| 1508896523 | Catherine Marie Chimo | Physician Assistant | 820 N Pine River St, Ithaca, MI 48847-1118 | 2006-07-04 |
| 1861470338 | Marissa Jodi Mcclintock | Physician Assistant | 107 Cayuga Heights Rd, Apt 11, Ithaca, NY 14850-2152 | 2006-01-05 |
| 1215549456 | Christina Maria Potter | Physician Assistant | 740 S Meadow St, Ithaca, NY 14850-5377 | 2020-08-19 |
| 1144855438 | Katherine Elizabeth Brotherton | Physician Assistant | 16 Brentwood Dr Ste A, Ithaca, NY 14850-1863 | 2020-03-06 |
| 1558993626 | Mikaela Katherine Hadaway | Physician Assistant | 16 Brentwood Dr Ste A, Ithaca, NY 14850-1863 | 2020-02-06 |
| Find all providers in ITHACA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.