Individual provider Active NPI

Bradley R Grimsley, MD

  • Vascular Surgery Physician
  • Dallas, TX
National Provider Identifier
1609830009
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
K8184 Issued in TX
Practice address
621 N Hall St
Ste 100
Dallas, TX 75226-1339
Phone
(214) 821-9600
Fax
(214) 823-5449
NPI assigned
Apr 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X K8184 TX
Vascular Surgery Physician 2086S0129X K8184 TX Primary

Addresses

Primary practice location

621 N Hall St
Ste 100
Dallas, TX 75226-1339

Mailing address

621 N Hall St
Ste 100
Dallas, TX 75226-1339
Phone (214) 821-9600

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100915000510 TX Practitioner - Vascular Surgery 4082613138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Emory University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

1901 N Macarthur Blvd
Irving, TX 75061-2220
Phone (972) 579-8485

2400 N I
Suite 35
Waxahachie, TX 75165-5240
Phone (817) 922-1770

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

611 N Hall St
400 Baylor Scott and White Cardiology Consult
Dallas, TX 75226-1337
Phone (469) 800-7400

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

  • Baylor Scott & White Heart & Vascular Hospital - Dallas Hospital, Dallas, TX, CCN 450851
  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)30
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K8184TXMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Aug 15, 2022 Accepting new patients
Healthtexas Provider Network CurrentSince Aug 15, 2022 Accepting new patients
Texas Vascular Associates Vascular Surgery CurrentSince Mar 1, 2001 Accepting new patients
Texas Heart Hospital of the Southwest LLC Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

621 N Hall St
Ste 100
Dallas, TX 75226
Phone (214) 820-0600

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3600 Gaston Ave
Ste 506
Dallas, TX 75246
Phone (214) 821-2274

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4716 Alliance Blvd
Ste 200
Plano, TX 75093
Phone (972) 665-9100

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

399 W Campbell Rd
Ste 300
Richardson, TX 75080
Phone (972) 665-9100

Interoperability endpoints

  • Direct secure messaging: bgrimsley457808@direct.sw.org

Ownership & related parties

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Baylor Scott & White the Heart Hospital - PlanoPlano, TX, CCN 670025 Hospital General Partnership Interest Aug 4, 2004
Baylor Scott & White the Heart Hospital - DentonDenton, TX, CCN 450893 Hospital General Partnership Interest Aug 4, 2004
Baylor Scott & White the Heart Hospital RehabilitationDenton, TX, CCN 67T347 Hospital General Partnership Interest Nov 1, 2024
Baylor Scott & White the Heart Hospital - CorinthDenton, TX, CCN 670347 Hospital General Partnership Interest Nov 1, 2024

Owned or controlled facilities with NPI records 4

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

Organizations & group practices 5

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 3

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": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1609830009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 N HALL ST",
            "address_2": "STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261339",
            "telephone_number": "214-821-9600",
            "fax_number": "214-823-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N HALL ST",
            "address_2": "STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752261339",
            "telephone_number": "214-821-9600",
            "fax_number": "214-823-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMSLEY",
        "first_name": "BRADLEY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-13",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K8184",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "K8184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.