Individual provider Active NPI

Bradley Allen Wilson, M.D.

  • Urology Physician
  • Norman, OK
National Provider Identifier
1407084791
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
30538 Issued in OK
Practice address
500 E Robinson Suite 1300
Norman Urology Associates, PC
Norman, OK 73071-6694
Phone
(405) 360-9966
Fax
(405) 360-9905
NPI assigned
Jun 25, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 30538 OK Primary

Addresses

Primary practice location

500 E Robinson Suite 1300
Norman Urology Associates, PC
Norman, OK 73071-6694

Mailing address

500 E Robinson Suite 1300
Norman Urology Associates, PC
Norman, OK 73071-6694
Phone (405) 360-9966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20140826002374 OK Practitioner - Urology 4981822350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Oklahoma College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norman Urology Associates PCGroup PAC ID 6103888961, 10 clinicians

Practice addresses (Care Compare)

500 E Robinson St
Suite 1300
Norman, OK 73071-6694
Phone (405) 360-9966

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection36
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30538OKMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Proton Center LLC CurrentSince Aug 1, 2023 Accepting new patients
Norman Urology Associates PC CurrentSince Sep 1, 2014 Accepting new patients
Grady Memorial Hospital Current Accepting new patients
Norman Regional Hospital Authority Past Accepting new patients
Community Hospital LLC Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

1019 N Council Ave
Ste 1
Blanchard, OK 73010
Phone (405) 485-9321

210 Mary Bailey
Chickasha, OK 73018
Phone (405) 222-9222

2100 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

2222 W Iowa Ave
Chickasha, OK 73018

2220 W Iowa Ave
Chickasha, OK 73018
Phone (405) 224-2100

3121 S Telephone Rd
Moore, OK 73160
Phone (405) 321-0370

2117 Riverwalk Dr
Moore, OK 73160
Phone (405) 610-1656

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

3300 Healthplex Pkwy
Norman, OK 73072
Phone (405) 329-4102

500 E Robinson St
Ste 1300
Norman, OK 73071
Phone (405) 360-9966

500 E Robinson St
Ste 300
Norman, OK 73071
Phone (405) 360-1118

100 SE 59th St
Oklahoma City, OK 73129
Phone (405) 364-9789

3100 SW 89th St
Oklahoma City, OK 73159
Phone (405) 602-8100

9500 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 475-0600

5901 W Memorial Rd
Oklahoma City, OK 73142
Phone (405) 773-6700

Interoperability endpoints

  • Direct secure messaging: bwilson@direct.gradymem.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Surgical Hospital of OklahomaOklahoma City, OK, CCN 370201 Hospital Limited Partnership Interest (1.58%) Nov 30, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1407084791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E ROBINSON SUITE 1300",
            "address_2": "NORMAN UROLOGY ASSOCIATES, PC",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716694",
            "telephone_number": "405-360-9966",
            "fax_number": "405-360-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E ROBINSON SUITE 1300",
            "address_2": "NORMAN UROLOGY ASSOCIATES, PC",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716694",
            "telephone_number": "405-360-9966",
            "fax_number": "405-360-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BRADLEY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "OK",
            "license": "30538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.