MEDICARE: NEW IMAGE MEDICAL INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	8638	NV

General Provider Information

NPI Number	:	1134660137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW IMAGE MEDICAL INC.

Provider Business Mailing Address
First Line	:	4474 SAGE BRUSH ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5711
Country	:	US
Telephone Number	:	877-302-8630
Fax Number	:	877-302-8630

Provider Business Practice Location Address
First Line	:	2610 S JONES BLVD STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5663
Country	:	US
Telephone Number	:	877-302-8630
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL LYNN BRADLEY
Credential	:
Telephone Number	:	877-302-8630

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	09/17/2025

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Directions to “NEW IMAGE MEDICAL INC. ” Practice Location

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