Individual provider Active NPI

Bradley Mohar, D.O.

  • Family Medicine Physician
  • Cheyenne, WY
National Provider Identifier
1013388545
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13210A Issued in WY
Practice address
214 E 23Rd St
Cheyenne, WY 82001-3748
Phone
(307) 634-2273
NPI assigned
Oct 9, 2015
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0069580 CO
Family Medicine Physician 207Q00000X TL6376 WY
Hospitalist Physician 208M00000X DR.0069580 CO
Hospitalist Physician 208M00000X TL6376 WY
Hospitalist Physician 208M00000X 13210A WY
Family Medicine Physician 207Q00000X 13210A WY Primary

Addresses

Primary practice location

214 E 23Rd St
Cheyenne, WY 82001-3748

Mailing address

PO Box 20970
Cheyenne, WY 82003-7020
Phone (307) 432-6629

Other practice location 1

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (248) 471-8000

Other practice location 2

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (248) 471-8000

Other practice location 3

5016 S US Highway 75
Denison, TX 75020
Phone (903) 416-4000

Other practice location 4

1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone (719) 776-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220919000791 CO Practitioner - HospitalistPractitioner - Internal Medicine 6507151925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Rocky Vista University College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone (719) 776-8040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DR.0069580COMDHospitalist Physician
13210AWYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 1, 2022 Accepting new patients
Portercare Adventist Health System CurrentSince Oct 1, 2022 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Oct 1, 2022 Accepting new patients
Portercare Adventist Health System CurrentSince Oct 1, 2022 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

100 Health Park Dr
Louisville, CO 80027
Phone (303) 673-1000

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1013388545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20970",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820037020",
            "telephone_number": "307-432-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E 23RD ST",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013748",
            "telephone_number": "307-634-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "248-471-8000",
            "fax_number": "248-615-7415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "248-471-8000",
            "fax_number": "248-615-7415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5016 S US Highway 75",
            "address_purpose": "LOCATION",
            "city": "Denison",
            "state": "TX",
            "postal_code": "75020",
            "country_code": "US",
            "telephone_number": "903-416-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1008 Minnequa Ave",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810043733",
            "country_code": "US",
            "telephone_number": "719-776-8040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAR",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-09",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0069580",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "TL6376",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "DR.0069580",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WY",
            "license": "TL6376",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WY",
            "license": "13210A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "13210A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.