Sean D Brodale, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3485 Issued in IA

Practice address

18754 US Highway 63
Bloomfield, IA 52537-6803

Phone

(641) 664-1799

Fax

(641) 664-1663

NPI assigned

May 12, 2006

Last updated

Jan 22, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

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

Merit-based Incentive Payment System (MIPS)

Final score

77.06 of 100Reported as group

Quality

64.36

Promoting interoperability

81

Improvement activities

40

Cost

75.01

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Henry County Health Center Inc

  • General Practice Physician
  • Mt Pleasant, IA
  • NPI 1871177477
  Medicare reassignment NPD
• Henry County Health Center, Inc.

  • Critical Access Hospital
  • Mt Pleasant, IA
  • NPI 1811571417
  Medicare reassignment NPD
• Southeast Iowa Regional Medical Center, Inc.

  dba Southeast Iowa Regional Medical Center

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884
  Medicare reassignment NPD
• Country Doctor PC

  • Family Medicine Physician
  • Bloomfield, IA
  • NPI 1326078130
  Authorized official Same address or phone

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1629029822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18754 US HIGHWAY 63",
            "city": "BLOOMFIELD",
            "state": "IA",
            "postal_code": "525376803",
            "telephone_number": "641-664-1799",
            "fax_number": "641-664-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18754 US HIGHWAY 63",
            "city": "BLOOMFIELD",
            "state": "IA",
            "postal_code": "525376803",
            "telephone_number": "641-664-1799",
            "fax_number": "641-664-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODALE",
        "first_name": "SEAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "IA",
            "license": "3485",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2424325",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209029206",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bloomfield Ia Skilled Nursing Facility LLC
• Bloomfield Ia Skilled Nursing Facility, LLC
• Dustin C Bozwell, CRNA/ARNP
• Jessica Leigh Brassfield
• Jay R Brewer, CRNA
• Jessica Christen
• Dorothy Cline-Campbell, D.O.
• Country Doctor PC
• Davis C.S.D.
• Davis County Hospital

• Family Medicine Physician in Bloomfield, IA
• Providers in Bloomfield, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.

Verify at the official NPI Registry.