Active NPI
Bradley Myren Anderson, MD
- Ophthalmology Physician
- Saint Cloud, MN
National Provider Identifier
1548258221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 43592
- Practice address
- 2055 15TH St N
Saint Cloud, MN 56303-1747 - Phone
- (320) 251-1432
- Fax
- (320) 251-7122
- NPI assigned
- Oct 7, 2005
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 43592 | MN | Primary |
Addresses
Primary practice location
2055 15TH St N
Saint Cloud, MN 56303-1747
Mailing address
2055 15TH St N
Saint Cloud, MN 56303-1747
Phone (320) 251-1432
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08-01106 | Other | MN | MEDICA |
| 527444300 | Medicaid | MN | |
| P00134021 | Other | RAILROAD MEDICARE | |
| 441T6AN | Other | MN | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- University of Minnesota Medical School, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2055 15TH St N
Saint Cloud, MN 56303-1747
Phone (320) 251-1432
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.1 of 100
- Quality
- 91.46
- Promoting interoperability
- 86
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.55 of 100
- Quality
- 91.59
- Improvement activities
- 40
- Cost
- 76.37
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 313 |
| Melanoma (skin cancer) excision | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Cloud Eye Clinic PA | Ophthalmology | Current | Accepting new patients |
| St Cloud Opticians | Ophthalmology | Past | Accepting new patients |
Locations
2055 15th St N
Saint Cloud, MN 56303
Phone (320) 251-1432
Interoperability endpoints
- bradley.anderson.p1@direct.stcloudeyeclinic.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- banderson1168@direct.centracare.com
Organizations & group practices 2
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.
-
- Ophthalmology Physician
- Saint Cloud, MN
- NPI 1538157805
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Litchfield, MN
- NPI 1598860215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329696000000",
"number": "1548258221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2055 15TH ST N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563031747",
"telephone_number": "320-251-1432",
"fax_number": "320-251-7122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2055 15TH ST N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563031747",
"telephone_number": "320-251-1432",
"fax_number": "320-251-7122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "BRADLEY",
"middle_name": "MYREN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-07",
"last_updated": "2012-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MN",
"license": "43592",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "08-01106",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "527444300",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00134021",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "441T6AN",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; 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.