Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Bradley Philip Coughlin, PA-C

Individual provider Surgical Physician Assistant · NPI 1053399451

Mr. Bradley Philip Coughlin, PA-C is a Physician Assistant in Colorado Springs, Colorado. Qualified in 2002, 24 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group and accepts Medicare assignment. Licensed in Colorado and Virginia.

Years since qualifying
24
Licensed in
CO, VA
In the registry since
2006
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

2767 Janitell Rd
Colorado Springs, CO 80906-4102
Phone: (719) 365-2888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 2850 (CO)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 0110002173 (VA)

Record details

NPI number1053399451
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 5, 2006
Last updated in NPPESMay 12, 2020
Certification dateMay 12, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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