Active NPI
Brian A Bradley, MD
- Urology Physician
- San Angelo, TX
National Provider Identifier
1356383269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- M3168
- Practice address
- 3605 Executive Dr
San Angelo, TX 76904-6884 - Phone
- (325) 949-9555
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | M3168 | TX | Primary |
Addresses
Primary practice location
3605 Executive Dr
San Angelo, TX 76904-6884
Mailing address
3605 Executive Dr
San Angelo, TX 76904-6884
Phone (325) 949-9555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8P9632 | Other | TX | BCBS OF TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060504000561 | TX | Practitioner - Urology | 2365424934 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Texas Medical Branch at Galveston, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shannon Clinic
Practice addresses (Care Compare)
120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511
Hospital & facility affiliations
- Shannon Medical Center
- Heart of Texas Memorial Hospital
- Ballinger Memorial Hospital
- Ut Health San Antonio Multispecialty & Research Ho
- Lillian M Hudspeth Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.63 of 100
- Quality
- 78.21
- Promoting interoperability
- 96
- Improvement activities
- 40
- Cost
- 67.22
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shannon Clinic | Current | Accepting new patients | |
| Shannon Clinic | Current | Accepting new patients | |
| Southeastern Integrated Medical PL | Past | Accepting new patients |
Locations
3555 Knickerbocker Rd
San Angelo, TX 76904
Phone (325) 224-5411
120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511
3605 Executive Dr
San Angelo, TX 76904
Phone (325) 949-9555
Interoperability endpoints
- bbradley10168@shannonhealth.direct-ci.com
Organizations & group practices 5
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.
-
- Durable Medical Equipment & Medical Supplies
- San Angelo, TX
- NPI 1124038633
-
- Rural Health Clinic/Center
- Ozona, TX
- NPI 1245230465
-
- Pediatrics Physician
- Del Rio, TX
- NPI 1790986719
-
- Neuromusculoskeletal Medicine & OMM Physician
- Gainesville, FL
- NPI 1871573949
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- San Antonio, TX
- NPI 1326829904
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543968000000",
"number": "1356383269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 EXECUTIVE DR",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769046884",
"telephone_number": "325-949-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 EXECUTIVE DR",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769046884",
"telephone_number": "325-949-9555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "BRIAN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2018-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TX",
"license": "M3168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TX",
"identifier": "8P9632",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.