NPIMap

Individual provider Active NPI

Bradley Allen Langley, MD

  • Family Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1083604722
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26499 Issued in MN
Practice address
3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Phone
(763) 587-7737
Fax
(763) 587-7069
NPI assigned
Oct 25, 2005
Last updated
May 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26499 MN Primary

Addresses

Primary practice location

3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761

Mailing address

3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Phone (763) 587-7737

Other identifiers 1

IdentifierTypeStateIssuer
256867500MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100510000252 MN Practitioner - Family Practice 2668500877 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriatric Services of Minnesota LLCGroup PAC ID 2365667557, 44 clinicians
Genevive Aco LLCGroup PAC ID 8628585080, 43 clinicians

Practice addresses (Care Compare)

3433 Broadway St NE
Suite 300
Minneapolis, MN 55413-1761
Phone (763) 587-7737

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genevive Aco LLC CurrentSince Sep 1, 2025 Accepting new patients
Geriatric Services of Minnesota, LLC CurrentSince Mar 1, 2020 Accepting new patients
Episcopal Homes on University Avenue, LLC Past Accepting new patients
Catholic Eldercare Past Accepting new patients
Parkway Clinic PLLC PastSince Jun 18, 2023 Accepting new patients
Episcopal Church Home of Minnesota Past Accepting new patients
Medexpress Urgent Care Minnesota P.C. Past Accepting new patients
New Harmony Care Center, Inc. Past Accepting new patients
CG Care Center, LLC. Past Accepting new patients

Locations

715 1st St N
Cold Spring, MN 56320
Phone (320) 685-3693

3433 Broadway St NE
Ste 300
Minneapolis, MN 55413

Organizations & group practices 9

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1083604722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131761",
            "telephone_number": "763-587-7737",
            "fax_number": "763-587-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131761",
            "telephone_number": "763-587-7737",
            "fax_number": "763-587-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGLEY",
        "first_name": "BRADLEY",
        "middle_name": "ALLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "26499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256867500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.