Bradley H Koffman, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

04-29308 Issued in KS

Practice address

5721 W 119TH St
Radiation Oncology Dept
Overland Park, KS 66209-3722

Phone

(913) 498-6270

Fax

(913) 498-6619

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

No

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 MO, KS2 enrollments

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 2

Specialty

Radiation Oncology

Education

University of Kansas School of Med (KC/Wich/Sal), 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Midwest Oncology Associates LLCGroup PAC ID 3779635172, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Menorah Medical Center Hospital, Overland Park, KS, CCN 170182
• Overland Park Reg Med Ctr Hospital, Overland Park, KS, CCN 170176
• Centerpoint Medical Center Hospital, Independence, MO, CCN 260095
• Research Medical Center Hospital, Kansas City, MO, CCN 260027
• St Lukes Hospital of Kansas City Hospital, Kansas City, MO, CCN 260138

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

• Village Shalom, Inc

  • Skilled Nursing Facility
  • Overland Park, KS
  • NPI 1316908163

  Corporate Director

  CMS ownership

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.

• Midwest Oncology Associates LLC

  • Hematology & Oncology Physician
  • Kansas City, MO
  • NPI 1699911677

  KS

  Medicare reassignment Care Compare group NPD
• Kansas City Urology Care, P.a.

  • Urology Physician
  • Overland Park, KS
  • NPI 1528024676
  NPD

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

• Midwest Division - MMC, LLC

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1255378337
  Care Compare affiliation
• Midwest Division-Oprmc LLC

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1578500484
  Care Compare affiliation
• Centerpoint Medical Center of Independence, LLC

  • General Acute Care Hospital
  • Independence, MO
  • NPI 1942247044
  Care Compare affiliation
• Midwest Division - RMC, LLC

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1134187842
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1063494177
  Care Compare affiliation
• St Lukes Hospital of Kansas City

  • General Acute Care Hospital
  • Kansas City, MO
  • NPI 1932642972
  Care Compare affiliation
• St. Luke'S Hospital of Kansas City

  • General Acute Care Hospital
  • Liberty, MO
  • NPI 1275926198
  Care Compare affiliation

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1659334282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 WINCHESTER AVE",
            "address_2": "SUITE 230",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641334677",
            "telephone_number": "816-313-2677",
            "fax_number": "816-313-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 W 119TH ST",
            "address_2": "RADIATION ONCOLOGY DEPT",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093722",
            "telephone_number": "913-498-6270",
            "fax_number": "913-498-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOFFMAN",
        "first_name": "BRADLEY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2001018673",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "KS",
            "license": "04-29308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2087439201",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205378607",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Koeneman Psychological Services, LLC
• Alysa Koeneman, MA, LPC
• Christopher D. Koenig, M.D.
• Madison Koerner
• Kristina Koettker
• Kevin Kohr, DPT
• Erika O Kokoruda, LMSW
• Barbara Jean Kolom, MA, CCC,SLP
• Denis Komen
• Thomas Kopatich, DC

• Radiation Oncology Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Radiation Oncology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.