BRADLEY DOUGLAS HAYNES DO
NPI 1801424981
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Active since April 01, 2020PECOS EnrolledAccepts Medicare Assignment
1402 S GRAND BLVD # M260, SAINT LOUIS, MO 63104(314) 268-7274 Get Directions Write a Review

NPPES record last updated: April 1, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bradley Douglas Haynes Do NPPES

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

BRADLEY DOUGLAS HAYNES DO (NPI 1801424981) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS and is a graduate of Kansas City University Of Med & Biosciences, College Of Osteo Med (2020).

NPPES Registry Identity

NPI1801424981
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBRADLEY DOUGLAS HAYNESCredential: DO
Location Address1402 S GRAND BLVD # M260Saint Louis, MO 63104-1004
Mailing Address866 Granada LnVacaville, CA 95688-2058 · (707) 235-5620
Sole ProprietorNo
Medical School CMSKansas City University Of Med & Biosciences, College Of Osteo MedGraduated 2020
Enumeration DateApril 1, 2020
NPPES CertifiedApril 1, 2020
NPI 1801424981 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1402 S GRAND BLVD # M260, Saint Louis, MO 63104

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

Bradley Douglas Haynes Do 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 ID7618394727
PECOS Enrollment IDI20241104003525
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.

Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
Otolaryngology
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104
Student in an Organized Health Care Education/Training Program
1402 S GRAND BLVD # M260
SAINT LOUIS, MO 63104

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 Bradley Haynes's NPI number?

The NPI number for Bradley Haynes is 1801424981. It was assigned to this individual provider in the NPPES registry on April 1, 2020.

Where is Bradley Haynes located?

Bradley Haynes practices at 1402 S Grand Blvd # M260, Saint Louis, MO 63104. The listed phone number is (314) 268-7274.

What is Bradley Haynes's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Bradley Haynes enrolled in Medicare?

Yes. Bradley Haynes 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 Bradley Haynes was last updated on April 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.