Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ty David Bradford, PA-C

Individual provider Physician Assistant · NPI 1053075077

Ty David Bradford, PA-C is a Physician Assistant in Salem, Oregon. Qualified in 2021, 5 years ago. Practices with Ideal Option PLLC, a 91-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California and Oregon.

Years since qualifying
5
Licensed in
CA, OR
In the registry since
2021
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

863 Liberty St NE
Salem, OR 97301-2451
Phone: (877) 522-1275
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 444 Bruce St, Yreka, CA 96097-3450 — (530) 842-4121

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA207912 (OR)
Physician Assistant Taxonomy 363A00000X · Licence PA60273 (CA)

Record details

NPI number1053075077
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 26, 2021
Last updated in NPPESMarch 4, 2025
Certification dateMarch 4, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ideal Option Pllc — 91 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations10 on file with Medicare

Other providers in Salem