NPIMap

Individual provider Active NPI

Brad Martin Solomon, D.O.

  • Gastroenterology Physician
  • Sioux Falls, SD
National Provider Identifier
1457693780
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OS020873 Issued in PA
Practice address
1205 S Grange Ave Ste 510
Sioux Falls, SD 57105-0410
Phone
(605) 328-8500
NPI assigned
Mar 25, 2013
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 336.100450 IL
Gastroenterology Physician 207RG0100X OS020873 PA Primary

Addresses

Primary practice location

1205 S Grange Ave Ste 510
Sioux Falls, SD 57105-0410

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other practice location 1

621 S Main St
Du Bois, PA 15801-1413
Phone (814) 371-0600

Other identifiers 1

IdentifierTypeStateIssuer
103832800MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230324002207 SD Practitioner - Gastroenterology 5799089587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1211 S Grange Ave
Sioux Falls, SD 57105-0402
Phone (605) 328-8500

1301 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-2200

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 312-7300

4405 E 26TH St
Sioux Falls, SD 57103-4187
Phone (605) 332-2883

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy99
Upper gastrointestinal (GI) endoscopy for acid reflux120

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
336.100450ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Internal Medicine CurrentSince Dec 20, 2022 Accepting new patients

Locations

1420 W 22nd St
Ste 510
Sioux Falls, SD 57105
Phone (605) 328-7500

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

Organizations & group practices 1

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.

Hospital & facility affiliations 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1457693780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "fax_number": "814-375-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 S GRANGE AVE STE 510",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050410",
            "telephone_number": "605-328-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "621 S Main St",
            "address_purpose": "LOCATION",
            "city": "Du Bois",
            "state": "PA",
            "postal_code": "158011413",
            "country_code": "US",
            "telephone_number": "814-371-0600",
            "fax_number": "814-372-4764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "BRAD",
        "middle_name": "MARTIN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "336.100450",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "OS020873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103832800",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.