NPIMap

Individual provider Active NPI

Bradley Clark Nelson, M.D.

  • Interventional Cardiology Physician
  • Reno, NV
National Provider Identifier
1093027799
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
20958 Issued in NV
Practice address
1500 E 2ND St Ste 400
Reno, NV 89502-1198
Phone
(775) 982-2400
Fax
(775) 982-2410
NPI assigned
Jul 9, 2010
Last updated
Jun 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X A117915 CA
Interventional Cardiology Physician 207RI0011X 20958 NV Primary

Addresses

Primary practice location

1500 E 2ND St Ste 400
Reno, NV 89502-1198

Mailing address

1155 Mill St # McM14
Reno, NV 89502-1576
Phone (775) 982-5262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140211001060 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3274762471 Reassigns benefits to 2 organizations
I20210726002310 NV Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 3274762471 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Colorado School of Medicine, Denver, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Services LLCGroup PAC ID 1951324318, 630 clinicians
Simonmed Reno PLLCGroup PAC ID 5991140360, 18 clinicians

Practice addresses (Care Compare)

10085 Double R Blvd
Suite 225
Reno, NV 89521-3855
Phone (775) 982-4035

1500 E 2ND St
Suite 400
Reno, NV 89502-1198
Phone (775) 982-2400

590 Eureka Ave
Reno Diagnostic Center Eureka
Reno, NV 89512-3425
Phone (775) 323-5083

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting86
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A117915CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Simonmed Reno PLLC CurrentSince Jun 1, 2024 Accepting new patients
Health Diagnostics of California a Professional Corporation CurrentSince Jun 1, 2024 Accepting new patients
Simonmed Reno PLLC CurrentSince Jun 1, 2024 Accepting new patients
Northern Inyo Healthcare District CurrentSince Sep 1, 2021 Accepting new patients
Community Care Services LLC Cardiovascular Disease Current Accepting new patients
Smi Imaging LLC CurrentSince Jun 1, 2024 Accepting new patients
Community Care Services LLC CurrentSince Apr 7, 2021 Accepting new patients
Northern Inyo Healthcare District CurrentSince Sep 1, 2021 Accepting new patients
Smi Imaging, LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

150 Pioneer Ln
Bishop, CA 93514
Phone (760) 873-2136

3061 S Maryland Pkwy
Ste 102
Las Vegas, NV 89109
Phone (702) 369-4570

1155 Mill St
#14
Reno, NV 89502

1155 Mill St
#M14
Reno, NV 89502
Phone (775) 258-1970

1500 E 2nd St
Ste 400
Reno, NV 89502

590 Eureka Ave
Reno, NV 89512
Phone (775) 323-5083

Interoperability endpoints

  • Direct secure messaging: bnelson172139@direct.renown.org

Organizations & group practices 10

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 7

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": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1093027799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST # MCM14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E 2ND ST STE 400",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021198",
            "telephone_number": "775-982-2400",
            "fax_number": "775-982-2410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRADLEY",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-09",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A117915",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NV",
            "license": "20958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.