Bradley William Reynolds, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Redlands, California. His current practice location is
1686 Barton Rd, Redlands, California. You can reach out to his office (for appointments etc.) via phone at
(909) 558-5948.
Bradley William Reynolds is licensed to practice in California (license number 32667) 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 1306362686.
Healthcare Provider's Profile
| Full Name | Bradley William Reynolds |
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| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 1686 Barton Rd, Redlands, California |
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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: 1306362686
- Provider Enumeration Date: 08/17/2017
- Last Update Date: 08/20/2024
Medicare PECOS Information:
- PECOS PAC ID: 7416351770
- Enrollment ID: I20210809001516
Medical Identifiers
Medical identifiers for Bradley William Reynolds such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1306362686 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | 32667 (California) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 32667 (California) | Primary |
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. Bradley William Reynolds allows following entities to bill medicare on his behalf.
| Entity Name | Department Of State Hospitals |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124078704
PECOS PAC ID: 9638174238
Enrollment ID: O20081031000305 |
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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. Bradley William Reynolds 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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Bradley William Reynolds, PHD
21111 Wood Ave Apt 16,
Torrance, CA 90503-4136
Ph: (714) 625-7232 | Bradley William Reynolds, PHD
1686 Barton Rd,
Redlands, CA 92373-1488
Ph: (909) 558-5948 |
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