Bryan David Netolicky, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

36197 Issued in IA

Practice address

1730 1St Ave NE
Cedar Rapids, IA 52402-5433

Phone

(319) 365-3993

Fax

(319) 364-0116

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Psychiatry

Education

University of Iowa, RJ & L Carver College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cedar Centre Psychiatric GroupGroup PAC ID 6204726342, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital, Cedar Rapids, IA, CCN 160045

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Cedar Centre Psychiatric Group

  • Psychiatry Physician
  • Cedar Rapids, IA
  • NPI 1558338012
  Medicare reassignment Care Compare group Authorized official
• Brandis McFarland Ma, LMHC Mental Health Counseling PLLC

  • Clinic/Center
  • Cedar Rapids, IA
  • NPI 1528573235
  NPD (past)

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

• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  Care Compare affiliation

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1255405338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1408",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524061408",
            "telephone_number": "319-365-3993",
            "fax_number": "319-364-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 1ST AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025433",
            "telephone_number": "319-365-3993",
            "fax_number": "319-364-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETOLICKY",
        "first_name": "BRYAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "36197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473249",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Nicole Nelson
• Jodi L Nelson, PT
• Patricia G Nelson, LISW
• Ronald Nelson, LPHD
• Jill Lynnette Nesham, AU.D.
• Nancy Kahle Netolicky, D.C.
• Julie Carol Netser, M.D.
• James L Neubauer, T-LMFT
• Lisa Mae Neuendorf, MSW, CADC
• Matthew A Neukirch, PHARM.D.

• Psychiatry Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Psychiatry Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.