NPIMap

Individual provider Active NPI

Bradley L Houston, MD

  • Family Medicine Physician
  • Red Wing, MN
National Provider Identifier
1275529240
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
72960 Issued in MN
Practice address
701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone
(651) 267-5000
NPI assigned
Sep 23, 2005
Last updated
Feb 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60758090 WA
Family Medicine Physician 207Q00000X 72960 MN Primary

Addresses

Primary practice location

701 Hewitt Blvd
Red Wing, MN 55066-2848

Mailing address

PO Box 850
Port Angeles, WA 98362-0146
Phone (360) 565-9237

Other practice location 1

433 E 8th St
Port Angeles, WA 98362-6219
Phone (360) 565-0999

Other identifiers 1

IdentifierTypeStateIssuer
036101327MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bhouston1863586@ehrdirect.mayoclinicmsg.org

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
I20230105002027 MN Practitioner - Family Practice 4587612064 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic Health System-Southeast Minnesota RegionGroup PAC ID 4385556703, shared by 9 NPIs, 550 clinicians

Practice addresses (Care Compare)

701 Hewitt Blvd
Red Wing, MN 55066-2848
Phone (651) 267-5000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60758090WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Jan 1, 2023 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 1, 2023 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jan 1, 2023 Accepting new patients
Bradley Houston M.D. Family Medicine PastSince Jan 1, 1990 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Past Accepting new patients
Richland Memorial Hospital, Inc Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

701 Hewitt Blvd
Red Wing, MN 55066
Phone (507) 377-6285

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Organizations & group practices 8

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 6

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1275529240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983620146",
            "telephone_number": "360-565-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HEWITT BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662848",
            "telephone_number": "651-267-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "433 E 8th St",
            "address_purpose": "LOCATION",
            "city": "Port Angeles",
            "state": "WA",
            "postal_code": "983626219",
            "country_code": "US",
            "telephone_number": "360-565-0999",
            "fax_number": "360-565-7610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "BRADLEY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60758090",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "72960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101327",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhouston1863586@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "701 Hewitt Blvd",
            "city": "Red Wing",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550662848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Red Wing, MN

Sources for this page

Verify at the official NPI Registry.