Individual provider Active NPI

Bradley Robert Mullen, M.D.

  • Diagnostic Radiology Physician
  • Wausau, WI
National Provider Identifier
1336253632
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
37599 Issued in AZ
Practice address
333 Pine Ridge Blvd
Wausau, WI 54401-4102
Phone
(715) 847-2283
NPI assigned
Aug 17, 2006
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X EMC0007015 MI
Diagnostic Radiology Physician 2085R0202X 35.140944 OH
Diagnostic Radiology Physician 2085R0202X 75187-20 WI
Diagnostic Radiology Physician 2085R0202X 37599 AZ Primary

Addresses

Primary practice location

333 Pine Ridge Blvd
Wausau, WI 54401-4102

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-8315

Other practice location 1

395 W 12th Ave
Columbus, OH 43210-1267
Phone (614) 293-8315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, FL, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080415000772 AZ Practitioner - Diagnostic Radiology 9830277904 Reassigns benefits to 7 organizations
I20231009002631 FL Practitioner - Diagnostic Radiology 9830277904 Reassigns benefits to 2 organizations
I20251009000418 OH Practitioner - Diagnostic Radiology 9830277904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Wausau SCGroup PAC ID 7618869587, 23 clinicians
Osu Radiology LLCGroup PAC ID 8921031675, 180 clinicians

Practice addresses (Care Compare)

1805 27TH St
Portsmouth, OH 45662-2640
Phone (740) 356-8681

3306 E Daley LN
Phoenix, AZ 85050-8411
Phone (715) 847-2283

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37599AZMDDiagnostic Radiology Physician
EMC0007015MIMDDiagnostic Radiology Physician
75187-20WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoran Radiology LTD Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Ohri, LLC CurrentSince Oct 1, 2023 Accepting new patients
Riverside Radiology and Interventional Associates Inc Diagnostic Radiology CurrentSince Apr 1, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2023 Accepting new patients
Ohi West Medical Group, LLC Diagnostic Radiology CurrentSince Nov 2, 2023 Accepting new patients
Somc Medical Care Foundation, Inc. Diagnostic Radiology CurrentSince Sep 15, 2025 Accepting new patients
Ohri, LLC Diagnostic Radiology Current Accepting new patients
Somc Medical Care Foundation, Inc. Current Accepting new patients
Lucidsolutions, Inc. Diagnostic Radiology CurrentSince Apr 1, 2021 Accepting new patients
Radiology Associates of Wausau, SC Diagnostic Radiology CurrentSince Jun 18, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2023 Accepting new patients
Carelife Imaging, LLC CurrentSince Sep 1, 2021 Accepting new patients
Osu Radiology LLC Diagnostic Radiology CurrentSince Oct 1, 2025 Accepting new patients
Associated Valley Radiologists LTD Diagnostic Radiology CurrentSince Mar 1, 2019 Accepting new patients
Smi Imaging, LLC Diagnostic Radiology CurrentSince Mar 1, 2021 Accepting new patients
Ohri, LLC CurrentSince Oct 1, 2023 Accepting new patients
Bayfront Health Imaging Center LLC Diagnostic Radiology Past Accepting new patients
Scottsdale Medical Imaging, LTD Diagnostic Radiology Past Accepting new patients
Med 97 LLC Past Accepting new patients

Locations (25 of 73)

3648 W Anthem Way
Ste A100
Anthem, AZ 85086
Phone (623) 434-6444

2050 W Southern Ave
Apache Junction, AZ 85120
Phone (480) 237-3200

1828 E Florence Blvd
Ste 118
Casa Grande, AZ 85122
Phone (520) 381-9729

1076 W Chandler Blvd
Ste 120
Chandler, AZ 85224
Phone (480) 821-9198

3645 S Rome St
Ste 101
Gilbert, AZ 85297

665 N Gilbert Rd
Ste 154
Gilbert, AZ 85234
Phone (480) 507-4500

18275 N 59th Ave
Ste 168
Glendale, AZ 85308

18275 N 59th Ave
Ste 168K
Glendale, AZ 85308
Phone (602) 889-1977

5310 W Thunderbird Rd
Ste 100
Glendale, AZ 85306
Phone (602) 978-0892

5555 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 588-5555

5601 W Eugie Ave
Ste 102
Glendale, AZ 85304
Phone (602) 588-3420

5605 W Eugie Ave
Ste 110
Glendale, AZ 85304
Phone (602) 938-2002

5757 W Thunderbird Rd
Ste W100
Glendale, AZ 85306
Phone (623) 931-7999

6220 W Bell Rd
Ste 110
Glendale, AZ 85308
Phone (602) 547-7230

13555 W McDowell Rd
Ste 106
Goodyear, AZ 85395
Phone (623) 535-0917

1052 E McKellips Rd
Mesa, AZ 85203
Phone (480) 425-5080

1201 S Alma School Rd
Ste 14500
Mesa, AZ 85210
Phone (602) 698-7715

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1450 S Dobson Rd
Ste A100
Mesa, AZ 85202
Phone (480) 545-9779

1940 S Country Club Dr
Ste 101
Mesa, AZ 85210
Phone (480) 476-8800

6424 E Broadway Rd
Ste 101
Mesa, AZ 85206
Phone (602) 830-0619

6553 E Baywood Ave
Ste 102
Mesa, AZ 85206
Phone (480) 268-7600

6644 E Baywood Ave
Mesa, AZ 85206
Phone (480) 321-2000

6750 E Baywood Ave
Mesa, AZ 85206
Phone (480) 854-5000

10575 N Tatum Blvd
Ste C128
Paradise Vly, AZ 85253
Phone (480) 998-1490

Networks

  • Freedom Health HMO Network

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1336253632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-8315",
            "fax_number": "614-293-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014102",
            "telephone_number": "715-847-2283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "395 W 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-293-8315",
            "fax_number": "614-293-6935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLEN",
        "first_name": "BRADLEY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "EMC0007015",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.140944",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "75187-20",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "37599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.