DR. BRADLEY PHILLIPS
NPI 1245798180
Pediatrics in Mountain Home Afb, ID

Q: What is Bradley Phillips's NPI number?

The NPI number for Bradley Phillips is 1245798180. It was assigned to this individual provider in the NPPES registry on March 11, 2019.

Q: What is Bradley Phillips's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Phillips was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since March 11, 2019PECOS Enrolled

90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648(208) 828-7362(208) 828-1916 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 3, 2026, Dec 1, 2025, May 8, 2024 and 3 more (6 updates tracked since 2019).

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About Dr. Bradley Phillips NPPES

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

DR. BRADLEY PHILLIPS (NPI 1245798180) is an individual pediatrics provider in Mountain Home Afb, Idaho, licensed in Idaho (M-17656) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS and maintains a secondary practice location in Boise.

NPPES Registry Identity

NPI1245798180

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. BRADLEY PHILLIPS

Location Address90 HOPE DR BLDG 6000Mountain Home Afb, ID 83648-1062

Mailing Address90 Hope DrMountain Home Afb, ID 83648-1057 · (208) 828-7362 · Fax (208) 828-1916

Phone(208) 828-7362

Fax(208) 828-1916

Sole ProprietorNo

Enumeration DateMarch 11, 2019

Last NPPES UpdateMarch 3, 20266 updates tracked since enumeration

NPPES CertifiedMarch 3, 2026

✔ NPI 1245798180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in ID · M-17656

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Also ListedPreventive Medicine · Aerospace MedicineTaxonomy 2083A0100X · License M-17656 (ID)

90 HOPE DR BLDG 6000, Mountain Home Afb, ID 83648

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Secondary Practice Location 1

Location 1190 E Bannock StBoise, ID 83712-6241 · Phone (208) 381-2645 · Fax (208) 381-7170

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Bradley Phillips is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83648 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

Most-billed visit code 99214

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 20

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

SHANNON L WILSON LCSW

Social Worker (Clinical)