Individual provider Active NPI

Bradley Joseph Bohnert, MD

  • Diagnostic Radiology Physician
  • Tucson, AZ
National Provider Identifier
1073583365
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
26545 Issued in AZ
Practice address
677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone
(520) 795-2889
Fax
(520) 795-6321
NPI assigned
Jan 26, 2006
Last updated
Feb 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 26545 AZ Primary
Neuroradiology Physician 2085N0700X 26545 AZ
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X 26545 AZ

Addresses

Primary practice location

677 N Wilmot Rd
Tucson, AZ 85711-2701

Mailing address

677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone (520) 795-2889

Other identifiers 7

IdentifierTypeStateIssuer
ZWCBBMOtherAZGROUP MEDICARE ID
508989MedicaidAZ
CS7943OtherAZGROUP MEDICARE RAILROAD ID & PTAN
005472OtherAZGROUP MEDICAID ID
1073583365OtherAZPHYSICIAN INDIVIDUAL NPI
1841261989OtherAZGROUP NPI
300111649OtherAZMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20090603000665 AZ Practitioner - Diagnostic Radiology 9931264199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of California, Geffen School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology LTD LLCGroup PAC ID 6204727589, 107 clinicians

Practice addresses (Care Compare)

677 N Wilmot Rd
Tucson, AZ 85711-2701
Phone (520) 571-9599

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.69 of 100Reported as group
Quality
75.27
Improvement activities
40
Cost
74.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26545AZMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RLC LLC Neuroradiology CurrentSince Dec 15, 2008 Accepting new patients
Arizona Oncology Associates PC Diagnostic Radiology CurrentSince Sep 1, 2023 Accepting new patients
Radiology LTD., LLC Diagnostic Radiology CurrentSince Jun 30, 2000 Accepting new patients
Arizona State Radiology, PC Diagnostic Radiology Past Accepting new patients

Locations

6320 W Union Hills Dr
Ste 1600
Glendale, AZ 85308
Phone (602) 357-2400

2551 E Vistoso Commerce Loop
Oro Valley, AZ 85755
Phone (520) 545-1966

3188 N Windsong Dr
Ste A
Prescott Valley, AZ 86314
Phone (928) 775-9430

1396 N Wilmot Rd
Tucson, AZ 85712
Phone (520) 324-2160

1400 N Wilmot Rd
Tucson, AZ 85712
Phone (520) 222-8268

1598 W Commerce Ct
Tucson, AZ 85746

1598 W Commerce Ct
#A
Tucson, AZ 85746
Phone (520) 290-4842

2625 N Craycroft Rd
Ste 100
Tucson, AZ 85712
Phone (520) 324-4214

2625 N Craycroft Rd
Ste 20
Tucson, AZ 85712
Phone (520) 324-2409

2945 W Ina Rd
Tucson, AZ 85741
Phone (520) 219-6616

2951 N Swan Rd
Ste 155
Tucson, AZ 85712
Phone (520) 323-5900

4640 E Camp Lowell Dr
Tucson, AZ 85712
Phone (520) 318-6144

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

5840 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 498-3900

5960 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 290-4848

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

6567 E Carondelet Dr
Ste 145
Tucson, AZ 85710
Phone (520) 290-4841

677 N Wilmot Rd
Tucson, AZ 85711
Phone (520) 571-9599

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1073583365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-795-2889",
            "fax_number": "520-795-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 N WILMOT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112701",
            "telephone_number": "520-795-2889",
            "fax_number": "520-795-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHNERT",
        "first_name": "BRADLEY",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "26545",
            "primary": true
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "AZ",
            "license": "26545",
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "AZ",
            "license": "26545",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE ID",
            "identifier": "ZWCBBM",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "508989",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE RAILROAD ID & PTAN",
            "identifier": "CS7943",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID ID",
            "identifier": "005472",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN INDIVIDUAL NPI",
            "identifier": "1073583365",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1841261989",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "300111649",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.