NPIMap

Individual provider Active NPI

Bradley Allen Lovan, PA-C

  • Physician Assistant
  • Minneapolis, MN
National Provider Identifier
1477178820
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14366 Issued in MN
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(612) 813-6000
NPI assigned
Jun 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 14366 MN
Physician Assistant 363A00000X 14366 MN Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-6000

Other practice location 1

913 E 26th St Ste 305
Minneapolis, MN 55404-4515
Phone (612) 871-7278

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bstaten647269@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20231024003510 MN Practitioner - Physician Assistant 8729401021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Pennsylvania State University College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

11850 Blackfoot St NW
Coon Rapids, MN 55433-2773

2925 Chicago Ave
Minneapolis, MN 55407-1321

333 Smith Ave N
Saint Paul, MN 55102-2344
Phone (651) 241-8000

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (763) 236-6000

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

800 E 28TH St
Minneapolis, MN 55407-3723

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jun 18, 2020 Accepting new patients
Allina Health System CurrentSince Dec 8, 2023 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jun 18, 2020 Accepting new patients
Allina Health System CurrentSince Dec 8, 2023 Accepting new patients
Allina Health System CurrentSince Feb 13, 2024 Accepting new patients
Allina Health System Past Accepting new patients

Locations

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

913 E 26th St
Ste 305
Minneapolis, MN 55404
Phone (612) 871-7278

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2855 Campus Dr
Ste 610
Plymouth, MN 55441
Phone (612) 333-4822

Organizations & group practices 8

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 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1477178820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "913 E 26th St Ste 305",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044515",
            "country_code": "US",
            "telephone_number": "612-871-7278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVAN",
        "first_name": "BRADLEY",
        "middle_name": "ALLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MN",
            "license": "14366",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bstaten647269@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "913 E 26th St Ste 305",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554044515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.