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TY DAVID BRADFORD PA-C
NPI 1053075077
Physician Assistant in Salem, OR

Active since October 26, 2021PECOS EnrolledAccepts Medicare Assignment
863 LIBERTY ST NE, SALEM, OR 97301(877) 522-1275 Get Directions Write a Review

NPPES record last updated: March 4, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 4, 2025, Jan 24, 2023 (2 updates tracked since 2023).

About Ty David Bradford Pa-c NPPES

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

TY DAVID BRADFORD PA-C (NPI 1053075077) is an individual physician assistant in Salem, Oregon, licensed in Oregon (PA207912) and active in the NPI registry since October 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1053075077
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameTY DAVID BRADFORDCredential: PA-C
Location Address863 LIBERTY ST NESalem, OR 97301-2451
Mailing Address500 Sw 7th St Ste A205Renton, WA 98057-2983 · (877) 522-1275 · Fax (833) 888-7145
Phone(877) 522-1275
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 26, 2021
Last NPPES UpdateMarch 4, 20252 updates tracked since enumeration
NPPES CertifiedMarch 4, 2025
✔ NPI 1053075077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in OR · PA207912✔ Licensed in CA · PA60273
Definition
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.
863 LIBERTY ST NE, Salem, OR 97301
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and more.Insurance ›

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

Ty David Bradford Pa-c 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 ID7012386717
PECOS Enrollment IDI20221219001762, I20231016000813
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
121 services16 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
96 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

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

IDEAL OPTION PLLC
Clinic/Center
863 LIBERTY ST NE
SALEM, OR 97301
Marion County (877) 522-1275
AIDAN S SORRELLS PSS
Peer Specialist
863 LIBERTY ST NE
SALEM, OR 97301
Marion County (877) 522-1275
JOSH LAIR CRM
Peer Specialist
863 LIBERTY ST NE
SALEM, OR 97301
Marion County (503) 399-5597

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 Ty Bradford's NPI number?

The NPI number for Ty Bradford is 1053075077. It was assigned to this individual provider in the NPPES registry on October 26, 2021.

Where is Ty Bradford located?

Ty Bradford practices at 863 Liberty St NE, Salem, OR 97301. The listed phone number is (877) 522-1275.

What is Ty Bradford's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Ty Bradford enrolled in Medicare?

Yes. Ty Bradford 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.

What insurance does Ty Bradford accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska and Providence Health Plan and 1 other insurer list Ty Bradford as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ty Bradford was last updated on March 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.