Individual provider Active NPI

Ryan Brady

  • Diagnostic Radiology Physician
  • St Louis Park, MN
National Provider Identifier
1639303704
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
57525 Issued in MN
Practice address
3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone
(952) 993-3700
NPI assigned
May 5, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 57525 MN Primary

Addresses

Primary practice location

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527

Mailing address

8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516

Other practice location 1

MMC 292 420 Delaware St SE
Minneapolis, MN 55455-0000
Phone (612) 626-3345

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140714001817 MN Practitioner - Diagnostic Radiology 5294950978 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Minnesota Medical School, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians
Tria Orthopaedic Center LLCGroup PAC ID 3173570561, 504 clinicians

Practice addresses (Care Compare)

12142 Business Park Blvd N
Champlin, MN 55316-4525
Phone (952) 977-0500

14000 Fairview Dr
Burnsville, MN 55337-5713
Phone (952) 993-8700

15111 Twelve Oaks Ctr Dr
Minnetonka, MN 55305-5201
Phone (952) 993-4500

15800 95TH Ave N
Maple Grove, MN 55369-4400
Phone (952) 993-1440

1885 Plaza Dr
Eagan, MN 55122-2979
Phone (952) 993-4001

2001 Blaisdell Ave
Minneapolis, MN 55404-2414
Phone (952) 993-8000

250 Central Ave N
Wayzata, MN 55391-1206
Phone (952) 993-3123

300 Lake Dr E
Chanhassen, MN 55317-9302
Phone (952) 993-4300

3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone (952) 993-3123

4155 County Rd 101
Plymouth, MN 55446-2307
Phone (952) 993-8900

4670 Park Nicollet Ave SE
Prior Lake, MN 55372-4119
Phone (952) 993-7750

4951 Excelsior Blvd
St Louis Park, MN 55416-3033
Phone (952) 993-1300

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

6000 Earle Brown Dr
Brooklyn Center, MN 55430-2506
Phone (952) 993-4900

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123

8100 Northland Dr
Bloomington, MN 55431-4800
Phone (952) 831-8742

8401 Golden Valley Rd
Golden Valley, MN 55427-4486
Phone (952) 993-8300

8455 Flying Cloud Dr
Eden Prairie, MN 55344-3974
Phone (952) 993-7400

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053
  • Hutchinson Health Hospital, Hutchinson, MN, CCN 240187
  • Olivia Hospital & Clinic Hospital, Olivia, MN, CCN 241306

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Jul 20, 2015 Accepting new patients
Fairview Health Services CurrentSince Aug 29, 2014 Accepting new patients
Park Nicollet Clinic CurrentSince Jul 20, 2015 Accepting new patients
Tria Orthopaedic Center LLC Diagnostic Radiology CurrentSince Jul 20, 2015 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Aug 29, 2014 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

606 24th Ave S
Minneapolis, MN 55454
Phone (612) 273-3332

8100 Northland Dr
Minneapolis, MN 55431
Phone (952) 831-1626

420 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-6483

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3850 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 883-1000

Organizations & group practices 6

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 8

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": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1639303704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 PARK NICOLLET BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "MMC 292 420 Delaware St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554550000",
            "country_code": "US",
            "telephone_number": "612-626-3345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADY",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-05",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "57525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.