Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bradley Glen Doll, PA-C

Individual provider Medical Physician Assistant · NPI 1720598972

Bradley Glen Doll, PA-C is a Physician Assistant in Omaha, Nebraska. Qualified in 2017, 9 years ago. Offers telehealth. Licensed in North Dakota and Nebraska.

Years since qualifying
9
Licensed in
ND, NE
In the registry since
2017
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4920 S 30th St Ste 103
Omaha, NE 68107-1656
Phone: (402) 734-4110
Fax: (402) 734-3990
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PAC0942 (ND)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 2172 (NE)

Record details

NPI number1720598972
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 2, 2017
Last updated in NPPESMay 2, 2022
Certification dateMay 2, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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