Individual provider Active NPI

Bradley R Dyer, M.D.

  • Hospitalist Physician
  • Saint Joseph, MO
National Provider Identifier
1023214509
Registry record updated Oct 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2015000100 Issued in MO
Practice address
5325 Faraon St
Ms 1020 Division of General and Geriatric Medicine Univ
Saint Joseph, MO 64506-3488
Phone
(816) 271-6406
NPI assigned
Jun 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2015000100 MO
Hospitalist Physician 208M00000X 05-35676 KS
Hospitalist Physician 208M00000X 2015000100 MO Primary

Addresses

Primary practice location

5325 Faraon St
Ms 1020 Division of General and Geriatric Medicine Univ
Saint Joseph, MO 64506-3488

Mailing address

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-6406

Other identifiers 3

IdentifierTypeStateIssuer
1023214509MedicaidMO
200865660CMedicaidKS
P01434619OtherMORR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150302000249 MO Practitioner - Internal Medicine 2163687807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Kansas City College of Medicine and Surgery, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-6406

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05-35676KSMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Regional Medical Center Internal Medicine CurrentSince Feb 1, 2015 Accepting new patients
Heartland Regional Medical Center Internal Medicine Current Accepting new patients
Heartland Regional Medical Center CurrentSince Feb 1, 2015 Accepting new patients
Heartland Regional Medical Center Past Accepting new patients

Locations

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

5325 Faraon St
Rm 1144
Saint Joseph, MO 64506

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1213

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

5325 Faraon St
#1020
Saint Joseph, MO 64506
Phone (816) 271-6406

Interoperability endpoints

  • Direct secure messaging: bradley.dyer@direct.mymlc.com

Organizations & group practices 4

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

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508371200000",
    "number": "1023214509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6406",
            "fax_number": "816-271-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "address_2": "MS 1020 DIVISION OF GENERAL AND GERIATRIC MEDICINE UNIV",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "BRADLEY",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2017-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2015000100",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "KS",
            "license": "05-35676",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MO",
            "license": "2015000100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023214509",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200865660C",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01434619",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.