Bradley Boman, DO
NPI 1861293243ActiveIndividual· Dermatology· Glendale, AZ
Dermatology (DO) in Glendale, Arizona, licensed in AZ, with an NPI issued in March 2025. Enrolled in Medicare as order and referring only - dermatology.
Overview
| NPI | 1861293243 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DO |
| Sole proprietor | No |
| NPI issued | Mar 21, 2025 |
| Last updated in NPPES | Aug 26, 2026 |
| Certified by provider | Aug 26, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | 012621 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Dermatology (NV) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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