NPIMap

Individual provider Active NPI

Brady Reese, D.O

  • Anesthesiology Physician
  • Saint Cloud, MN
National Provider Identifier
1306109673
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0102203552 Issued in VA
Practice address
3701 12TH St N Ste 2020
Saint Cloud, MN 56303-2255
Phone
(320) 258-3090
Fax
(320) 258-3095
NPI assigned
Jun 20, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 6

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

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare Clinic 800 clinicians

Practice addresses (Care Compare)

3701 12TH St N
Suite 202
Saint Cloud, MN 56303-2253
Phone (320) 258-3090

Hospital & facility affiliations

  • Centracare - St. Cloud Hospital Hospital, Saint Cloud, MN, CCN 240036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MN2 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
I20191030001874 TX Practitioner - Anesthesiology 6507198223 Reassigns benefits to 1 organization
I20210513000375 MN Practitioner - Anesthesiology 6507198223 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102203552VAMDMilitary Health Care Provider

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic CurrentSince Apr 1, 2021 Accepting new patients
Austin Anesthesiology Group, PLLC Anesthesiology CurrentSince Oct 1, 2019 Accepting new patients
Centracare Clinic CurrentSince Apr 1, 2021 Accepting new patients
Austin Anesthesiology Group PLLC Anesthesiology CurrentSince Oct 1, 2019 Accepting new patients
Centracare Clinic Current Accepting new patients

Locations

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

3701 12th St N
Ste 202
Saint Cloud, MN 56303
Phone (320) 258-3090

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

Interoperability endpoints

  • Direct secure messaging: breese572598@direct.centracare.com

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X 0102203552 VA
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 0102203552 VA Primary

Addresses

NPPES NPI Registry

Primary practice location

3701 12TH St N Ste 2020
Saint Cloud, MN 56303-2255

Mailing address

3701 12TH St N Ste 2020
Saint Cloud, MN 56303-2255
Phone (320) 258-3090

Other practice location 1

8901 Rockville Pike
Bethesda, MD 20889-0001
Phone (301) 295-4000

Other practice location 2

36065 Santa Fe Ave
Fort Hood, TX 76544
Phone (254) 288-8000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 23, 2021.

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1306109673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 12TH ST N STE 2020",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032255",
            "telephone_number": "320-258-3090",
            "fax_number": "320-258-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 12TH ST N STE 2020",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563032255",
            "telephone_number": "320-258-3090",
            "fax_number": "320-258-3095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8901 Rockville Pike",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890001",
            "country_code": "US",
            "telephone_number": "301-295-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36065 Santa Fe Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Hood",
            "state": "TX",
            "postal_code": "76544",
            "country_code": "US",
            "telephone_number": "254-288-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REESE",
        "first_name": "BRADY",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "0102203552",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0102203552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.