Dylan Bray, AA is a medicare enrolled "Anesthesiologist Assistant" in Brookfield, Wisconsin. His current practice location is
225 S Executive Dr, Brookfield, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(608) 770-0908.
Dylan Bray is licensed to practice in Wisconsin (license number 82-17) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1790135457.
Provider's Profile
| Full Name | Dylan Bray |
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| Gender | Male |
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| Speciality | Anesthesiologist Assistant |
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| Location | 225 S Executive Dr, Brookfield, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1790135457
- Provider Enumeration Date: 06/14/2016
- Last Update Date: 06/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 9739474438
- Enrollment ID: I20160819000626
Medical Identifiers
Medical identifiers for Dylan Bray such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790135457 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367H00000X | Anesthesiologist Assistant | 82-17 (Wisconsin) | Primary |
| 367H00000X | Anesthesiologist Assistant | ANT.0000131 (Colorado) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dylan Bray allows following entities to bill medicare on his behalf.
| Entity Name | Aurora Medical Group, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427271378
PECOS PAC ID: 6709794258
Enrollment ID: O20031105000725 |
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| Entity Name | Madison Anesthesiology Consultants, Llp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669550711
PECOS PAC ID: 5193700342
Enrollment ID: O20040622000357 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dylan Bray is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dylan Bray, AA
2135 N Lake Dr,
Milwaukee, WI 53202-1334
Ph: () - | Dylan Bray, AA
225 S Executive Dr,
Brookfield, WI 53005-4257
Ph: (608) 770-0908 |
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