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MR. LARRY JOE BRIDWELL JR. FNP
NPI 1043362296
Registered Nurse in Oakland, CA

Active since January 17, 2007PECOS EnrolledAccepts Medicare Assignment
280 W MACARTHUR BLVD, OAKLAND, CA 94611(510) 752-0164(510) 752-7014 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Larry Joe Bridwell Jr. Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. LARRY JOE BRIDWELL JR. FNP (NPI 1043362296) is an individual registered nurse in Oakland, California, licensed in California (547388) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1043362296
Entity TypeIndividualMale
Primary Taxonomy163W00000X
Provider Legal NameMR. LARRY JOE BRIDWELL JR.Credential: FNP
Location Address280 W MACARTHUR BLVDOakland, CA 94611-5642
Mailing Address280 W Macarthur BlvdOakland, CA 94611-5642 · (510) 752-0164 · Fax (510) 752-7014
Phone(510) 752-0164
Fax(510) 752-7014
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateJanuary 17, 2007
Last NPPES UpdateFebruary 11, 2022
✔ NPI 1043362296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered NurseNursing Service Providers
Taxonomy Code163W00000X
License✔ Licensed in CA · 547388
Definition
(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span.
280 W MACARTHUR BLVD, Oakland, CA 94611
Open in Google Maps ↗

Other Identifiers 1

Other16829CA · Np

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Larry Joe Bridwell Jr. Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103923586
PECOS Enrollment IDI20070518000376
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSICA CHANG PHARM.D., APH
Pharmacist
280 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-8859
NORMA MIYEKO MARUBAYASHI HOLLOWAY PHARMD
Pharmacist
280 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-6468
DIANA HIROS CRNA
Nurse Anesthetist, Certified Registered
280 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-6238
IVY I. YU MD
Obstetrics & Gynecology
280 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
THERESE M. HICKEY MD
Anesthesiology
280 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
JOHN L. JONES MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
280 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-1000
ANNETTE CHENEVEY CRNA
Nurse Anesthetist, Certified Registered
280 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-6238
MRS. MICHELE NG PHARM.D.
Pharmacist
280 W MACARTHUR BLVD
OAKLAND, CA 94611
Alameda County (510) 752-6141

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Larry Bridwell's NPI number?

The NPI number for Larry Bridwell is 1043362296. It was assigned to this individual provider in the NPPES registry on January 17, 2007.

Where is Larry Bridwell located?

Larry Bridwell practices at 280 W Macarthur Blvd, Oakland, CA 94611. The listed phone number is (510) 752-0164.

What is Larry Bridwell's specialty?

The primary specialty registered for this NPI is Registered Nurse with taxonomy code 163W00000X.

Is Larry Bridwell enrolled in Medicare?

Yes. Larry Bridwell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Larry Bridwell was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.