Individual provider Active NPI

Brian Paul Bradow, M.D.

  • Plastic Surgery Physician
  • Denver, CO
National Provider Identifier
1184895146
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
0056508 Issued in CO
Practice address
2045 N Franklin St
Denver, CO 80205-5437
Phone
(303) 338-4545
NPI assigned
Mar 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT188778 PA
Plastic Surgery Physician 208200000X 0056508 CO Primary
Plastic Surgery Physician 208200000X 35098881 OH

Addresses

Primary practice location

2045 N Franklin St
Denver, CO 80205-5437

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other identifiers 3

IdentifierTypeStateIssuer
027080OtherCOKAISER COMMERCIAL NUMBER
0066268MedicaidOH
3810023423MedicaidWV

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
I20160505000369 CO Practitioner - Plastic and Reconstructive Surgery 7618133455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Rutgers New Jersey Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Permanente Medical Group PCGroup PAC ID 1254238454, 1,325 clinicians

Practice addresses (Care Compare)

10350 E Dakota Ave
Denver, CO 80247-1314

10350 E Dakota Avenue B
Kaiser Permanente High
Denver, CO 80247-1314
Phone (303) 338-4545

10350 E Dakota Avenue C
Kaiser Permanente Highline Chemical
Denver, CO 80247-1314
Phone (303) 338-4545

2045 N Franklin St
Kaiser Permanente Franklin Medical
Denver, CO 80205-5437
Phone (303) 338-4545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0056508COMDPlastic Surgery Physician
35098881OHMDPlastic Surgery Physician
MT188778PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Hospital, Inc Surgery Current Accepting new patients
Kaiser Foundation Health Plan of Colorado CurrentSince May 9, 2016 Accepting new patients
Colorado Permanente Medical Group, P.C. Surgery CurrentSince May 9, 2016 Accepting new patients
Saint Joseph Hospital, Inc CurrentSince May 9, 2016 Accepting new patients
Saint Joseph Hospital Inc CurrentSince May 9, 2016 Accepting new patients
Peoria Surgical Group, LTD. Surgery PastSince Aug 19, 2013 Accepting new patients

Locations

1375 E 19th Ave
Denver, CO 80218
Phone (303) 812-2000

10350 E Dakota Ave
Denver, CO 80247
Phone (303) 636-3350

1825 N Marion St
Denver, CO 80218
Phone (303) 318-3434

2045 N Franklin St
Denver, CO 80205
Phone (303) 764-4666

1960 N Ogden St
Ste 330
Denver, CO 80218
Phone (303) 318-2610

Interoperability endpoints

  • Direct secure messaging: brian.bradow.1@30093.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1184895146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 N FRANKLIN ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055437",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADOW",
        "first_name": "BRIAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-18",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT188778",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CO",
            "license": "0056508",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "35098881",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "027080",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0066268",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023423",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2045 N Franklin St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802055437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.