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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

AUDREY ELISE BRADFORD
NPI 1578415089
Physician Assistant in Fort Wayne, IN

Active since February 10, 2026PECOS Enrolled
1660 BROADWAY STE 165, FORT WAYNE, IN 46802(260) 266-9805(260) 266-9815 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 10, 2026, Mar 12, 2026 (2 updates tracked since 2026).

About Audrey Elise Bradford NPPES

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

AUDREY ELISE BRADFORD (NPI 1578415089) is an individual physician assistant in Fort Wayne, Indiana, licensed in Indiana (10005240A) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1578415089
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameAUDREY ELISE BRADFORD
Location Address1660 BROADWAY STE 165Fort Wayne, IN 46802-0011
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
Phone(260) 266-9805
Fax(260) 266-9815
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 10, 2026
Last NPPES UpdateJuly 10, 20262 updates tracked since enumeration
NPPES CertifiedJuly 10, 2026
✔ NPI 1578415089 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 IN · 10005240A✔ Licensed in MI · 5601013822
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.
1660 BROADWAY STE 165, Fort Wayne, IN 46802
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Audrey Elise Bradford is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3971071812
PECOS Enrollment IDI20260508000905
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 46802 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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.

MR. JASPREET S JAWANDA M.D.
Family Medicine
1660 BROADWAY STE 165
FORT WAYNE, IN 46802
Allen County (260) 266-9805
MRS. DELANEY L KAISER RN, NP
Nurse Practitioner
1660 BROADWAY STE 165
FORT WAYNE, IN 46802
Allen County (260) 266-9805
MR. MATT RYAN GIVENS LMFT
Marriage & Family Therapist
1660 BROADWAY STE 165
FORT WAYNE, IN 46802
Allen County (260) 266-9805

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 Audrey Bradford's NPI number?

The NPI number for Audrey Bradford is 1578415089. It was assigned to this individual provider in the NPPES registry on February 10, 2026.

Where is Audrey Bradford located?

Audrey Bradford practices at 1660 Broadway Ste 165, Fort Wayne, IN 46802. The listed phone number is (260) 266-9805.

What is Audrey Bradford's specialty?

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

Is Audrey Bradford enrolled in Medicare?

Yes. Audrey Bradford is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Audrey Bradford was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days 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.