DR. CHARLES RAYMOND BRADFORD III M.D.
NPI 1700805082
Family Medicine in Scottsboro, AL


Quality Rating: 95.83 out of 100 score

NPI Status: Active since July 18, 2006

Contact Information

508 HARLEY ST
SUITE D
SCOTTSBORO, AL
ZIP 35768
Phone: (256) 259-6054
Fax: (256) 259-5206

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  • Individual
  • Male
  • Years of Experience 49
  • Family Medicine
  • PECOS Enrolled
  • Accepts Medicare Approved Payment
  • Medicare Quality Reporting

About CHARLES BRADFORD

Charles Bradford is a primary care provider established in Scottsboro, Alabama and his medical specialization is Family Medicine with more than 49 years of experience. He graduated from University Of Alabama School Of Medicine in 1975. The healthcare provider is registered in the NPI registry with number 1700805082 assigned on July 2006. The practitioner's primary taxonomy code is 207Q00000X with license number 00007481 (AL). The provider is registered as an individual and his NPI record was last updated 17 years ago.

NPI
1700805082
Provider Name
DR. CHARLES RAYMOND BRADFORD III M.D.
Gender
Male
Entity Type
Individual
Location Address
508 HARLEY ST SUITE D SCOTTSBORO, AL 35768
Location Phone
(256) 259-6054
Location Fax
(256) 259-5206
Mailing Address
141 PINE POINT RD SCOTTSBORO, AL 35769
Mailing Phone
(256) 259-9425
Medical School Name
UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year
1975
Is Sole Proprietor?
Yes
Enumeration Date
07-18-2006
Last Update Date
07-08-2007
Code Navigator

A primary care provider (PCP) like Charles Bradford sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Charles Bradford is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 95.83, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The following quality measures were reported for this provider: breast cancer screening, chronic care and preventative care management for empaneled patients, colorectal cancer screening, diabetes: eye exam, immunization registry reporting, implementation of medication management practice improvements, measurement and improvement at the practice and panel level, medication reconciliation, patient-specific education, preventive care and screening: influenza immunization, provide patient access, secure messaging, security risk analysis, specialized registry reporting and use of decision support and standardized treatment protocols.

The typical physician office visit costs for Medicare beneficiaries in this area are: $21.48 for a new patient copayment and $24.83 for an established patient copayment.

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
00007481
License State
AL
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Cross and Blue Shield of Alabama

    • Blue Cross Select Gold - PPO
    • Blue Cross Select Silver - PPO
    • Blue HSA Bronze - PPO
    • Blue Protect - PPO
    • Blue Saver Bronze - PPO
    • Blue Standardized Bronze - PPO
    • Blue Standardized Gold - PPO
    • Blue Standardized Silver - PPO
    • Blue Value Gold - PPO
    • Blue Value Silver - PPO
    • Blue Access Gold for Business - PPO
    • Blue Choice Platinum for Business - PPO
    • Blue HSA Silver for Business - PPO
    • Blue Saver Bronze for Business - PPO
    • Blue Saver Gold for Business - PPO
  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
C72017MEDICARE UPIN (02)AL 
000003793MEDICARE ID-TYPE UNSPECIFIED (04)AL 

PECOS Enrollment and Medicare Participation Status

Charles Bradford is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3476730482

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20110531000299

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Provider Referred Orders for Durable Medical Equipment, Devices & Supplies

The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.

Durable Medical Equipment

  • Other DME (D1E)

    Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)

    4 DME suppliers used 30 Medicare Claims 63 Services Paid

  • Other DME (D1E)

    Headgear used with positive airway pressure device (HCPCS:A7035)

    3 DME suppliers used 12 Medicare Claims 12 Services Paid

  • Oxygen and supplies (D1C)

    Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)

    2 DME suppliers used 13 Medicare Claims 13 Services Paid

  • Oxygen and supplies (D1C)

    Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)

    3 DME suppliers used 28 Medicare Claims 28 Services Paid

  • Oxygen and supplies (D1C)

    Portable oxygen concentrator, rental (HCPCS:E1392)

    2 DME suppliers used 15 Medicare Claims 15 Services Paid

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 35768 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $85.95
  • Minimum New Patient Price $55.54
  • Maximum New Patient Price $170.61
  • Average New Patient Copayment $21.48
  • Minimum New Patient Copayment $13.88
  • Maximum New Patient Copayment $42.65

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.33
  • Minimum Established Patient Price $16.93
  • Maximum Established Patient Price $139.08
  • Average Established Patient Copayment $24.83
  • Minimum Established Patient Copayment $4.23
  • Maximum Established Patient Copayment $34.77

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

  • Final Score: 95.83 out of 100

    The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.

  • Quality Score: 95.1

    The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

    There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.

  • Promoting Interoperability Score: N/A

    The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

    The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.

  • Improvement Activities Score: 40

    The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

    The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

  • Cost Score: N/A

    The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

    Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The following quality measures meet Medicare's statistical reporting standards for the year 2018. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Breast Cancer Screening 60% 368
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Colorectal Cancer Screening 41% 764
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Diabetes: Eye Exam 20% 241
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
Immunization Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation 100% 76
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education 82% 1430
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Preventive Care and Screening: Influenza Immunization 18% 1079
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
Provide Patient Access 82% 1430
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging 7% 1430
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

Clinician Services

The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2020. The reported codes are based on the top 5 codes for each available specialty, excluding evaluation and management codes.

  • 947

    Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)

  • 506

    Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)

  • 124

    Automated urinalysis test (HCPCS:81003)

  • 64

    Administration of influenza virus vaccine (HCPCS:G0008)

  • 63

    Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

  • 62

    Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck (HCPCS:93880)

  • 43

    Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour (HCPCS:96365)

  • 42

    Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)

  • 21

    Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)

  • 18

    Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem (HCPCS:G0180)

  • 17

    Ultrasound of head and neck (HCPCS:76536)

  • 13

    Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)

  • 13

    Ultrasound study of arteries of both arms and legs (HCPCS:93922)

  • 12

    Urinalysis, manual test (HCPCS:81002)

Hospital Affiliations

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Charles Bradford is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
HUNTSVILLE HOSPITAL101 SIVLEY RD
HUNTSVILLE, AL 35801
(256) 265-1000Acute Care Hospitals
HIGHLANDS MEDICAL CENTER380 WOODS COVE ROAD
SCOTTSBORO, AL 35768
(256) 259-4444Acute Care Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1700805082
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
270016010016
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 0 + 0 + 1 + 6 + 0 + 1 + 0 + 0 + 1 + 6 + 24 = 48
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 48 = 22

The NPI number 1700805082 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1659343200DR. ETHAN BARUCH RUBEN M.D.
Individual
Pediatrics508 HARLEY ST SUITE C
SCOTTSBORO, AL 35768
(256) 259-5537
1659487411CHAD BRADFORD M.D.P.C.
Organization
Family Medicine508 HARLEY ST SUITE B
SCOTTSBORO, AL 35768
(256) 259-0734
1295828036JACKSON COUNTY FAMILY CARE CLINIC
Organization
Family Medicine508 HARLEY ST SUITE C
SCOTTSBORO, AL 35768
(256) 259-5537
1902205883 LINDSEY DICUS WHITE NP-C
Individual
Nurse Practitioner (Family)508 HARLEY ST SUITE D
SCOTTSBORO, AL 35768
(256) 575-9044
1427141241DR. WILLIAM HARDIN COLEMAN JR. M.D.
Individual
Family Medicine508 HARLEY ST SUITE C
SCOTTSBORO, AL 35768
(256) 259-5537
1366868531JACKSON COUNTY FAMILY MEDICINE LLC
Organization
Family Medicine508 HARLEY ST STE C
SCOTTSBORO, AL 35768
(256) 259-5537
1407284532BRADFORD FAMILY HEALTHCARE PC
Organization
Clinic/Center (Health Service)508 HARLEY ST SUITE D
SCOTTSBORO, AL 35768
(256) 259-6054
1427085133DR. CHARLES RAYMOND BRADFORD IV M.D.
Individual
Family Medicine508 HARLEY ST SUITE B
SCOTTSBORO, AL 35768
(256) 259-0734

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1700805082, enumerated in the NPI registry as an "individual" on July 18, 2006

The provider is located at 508 Harley St Suite D Scottsboro, Al 35768 and the phone number is (256) 259-6054

The provider's speciality is Family Medicine with taxonomy code 207Q00000X

The provider has more than 49 years of experience. He graduated from University Of Alabama School Of Medicine in 1975.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Alabama, Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of May 10, 2024 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences.

Medicare beneficiaries should expect a typical cost of $85.95 with an average copayment of $21.48 for new patient appointments. Established patients should expect a typical charge of $99.33 and an average copayment of 24.83. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Injection, triamcinolone acetonide, not otherwise specified, 10 mg, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Automated urinalysis test, Administration of influenza virus vaccine, Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, Ultrasound scanning of blood flow (outside the brain) on both sides of head and neck, Infusion into a vein for therapy, prevention, or diagnosis up to 1 hour, Routine ekg using at least 12 leads including interpretation and report, Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function, Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem, Ultrasound of head and neck, Aspiration and/or injection of large joint or joint capsule, Ultrasound study of arteries of both arms and legs and Urinalysis, manual test.

The practitioner is affiliated to the following hospital(s): HUNTSVILLE HOSPITAL and HIGHLANDS MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on July 18, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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