Bradley W Dyrstad, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

P4440 Issued in TX

Practice address

1 Parks Legado CT
Odessa, TX 79765-2542

Phone

(432) 332-2663

Fax

(432) 335-8849

NPI assigned

Jul 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Southern Illinois University School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Basin Orthopedic Surgical Specialists, P.a.Group PAC ID 3870403363, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Midland Memorial Hospital Hospital, Midland, TX, CCN 450133
• Medical Center Hospital Hospital, Odessa, TX, CCN 450132

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bdyrstad@boss.directglo.com
• Direct secure messaging: bdyrstad@bossrefine.emadirect.md

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.

• Basin Orthopedic Surgical Specialists, P.a.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Odessa, TX
  • NPI 1164432746
  Medicare reassignment Care Compare group NPD

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

• Ector County Hospital District

  • Federally Qualified Health Center (FQHC)
  • Odessa, TX
  • NPI 1578265302

  Hospital

  Care Compare affiliation
• Ector County Hospital District

  • General Acute Care Hospital
  • Odessa, TX
  • NPI 1740273994
  Care Compare affiliation
• Midland County Hospital District

  • General Acute Care Hospital
  • Midland, TX
  • NPI 1255325817
  Care Compare affiliation

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1366641789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARKS LEGADO CT",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797652542",
            "telephone_number": "432-332-2663",
            "fax_number": "432-335-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARKS LEGADO CT",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797652542",
            "telephone_number": "432-332-2663",
            "fax_number": "432-335-8849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYRSTAD",
        "first_name": "BRADLEY",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35.099289",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "60790",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125-052536",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "P4440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kacee Dunavan, FNP
• Kyle Stephen Dunaway, CRNA
• Kathy Kim-Nhung Duong
• Santhosh Duraisamy, M.D.
• Harvey J Durbin Jr., PHD
• East Odessa Dental and Orthodontics PLLC
• Easy Optimistic Living Counseling
• Easy Way Ramps LLC
• Ector County
• Ector County Hospital District

• Orthopaedic Surgery Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.