Jon Edwin Bradbury, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

43109 Issued in MN

Practice address

929 Central Ave. NW
East Grand Forks, MN 56721

Phone

(218) 773-6800

Fax

(218) 773-6861

NPI assigned

Jun 8, 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 7

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN, ND2 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

Family Practice

Education

University of North Dakota School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford Medical Center Fargo 1,210 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Altru'S Home Health Home health agency, Grand Forks, ND, CCN 357014
• Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011
• Altru Hospital Hospital, Grand Forks, ND, CCN 350019

Merit-based Incentive Payment System (MIPS)

Final score

88.99 of 100Reported as group

Quality

92.39

Promoting interoperability

100

Improvement activities

40

Cost

70.9

Merit-based Incentive Payment System (MIPS)

Final score

82.73 of 100Reported as group

Quality

71.75

Promoting interoperability

100

Improvement activities

40

Cost

70.68

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbradbury1841261@direct.sanfordhealth.org

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.

• Sanford Medical Center Fargo

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  Family Medicine, MN, ND

  Medicare reassignment NPD
• Sanford Medical Center Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD
• Sanford Clinic North

  • Internal Medicine Physician
  • Detroit Lakes, MN
  • NPI 1235170747

  Family Medicine

  NPD (past)

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

• Sanford Health of Northern Minnesota

  • Ambulatory Surgical Clinic/Center
  • Bemidji, MN
  • NPI 1093876922

  Hospital

  Care Compare affiliation
• Altru Health System

  • General Acute Care Hospital
  • Grand Forks, ND
  • NPI 1154346161

  Hospital

  Care Compare affiliation
• Altru Health System

  • Home Health Agency
  • Grand Forks, ND
  • NPI 1346339850
  Care Compare affiliation
• Sanford Medical Center Fargo

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  Hospital

  Care Compare affiliation
• Sanford Medical Center Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1245519081

  Hospital

  Care Compare affiliation
• Sanford Medical Center Fargo

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412

  Hospital

  Care Compare affiliation
• Sanford Medical Center Fargo

  • Air Ambulance
  • Fargo, ND
  • NPI 1942415468

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1679514285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 CENTRAL AVE. NW",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "56721",
            "telephone_number": "218-773-6800",
            "fax_number": "218-773-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBURY",
        "first_name": "JON",
        "middle_name": "EDWIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "8277",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "43109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26520",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "NA4571025060",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11142",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420032200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "500M4BR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0123581",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP31099",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbradbury1841261@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "929 Central Ave. NW",
            "city": "East Grand Forks",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea M Auch, PT
• Balm of Gilead Healthcare Clinic LLC
• Balm of Gilead Healthcare LLC
• Robert William Beattie, M.D
• Kaitlyn Elizabeth Benz, LSW, LADC
• Craig W. Burns, LMSW
• Jennifer Byfuglien, DO
• Thomas Bradley Cariveau, MD
• Marlo Cochran
• Destin Ross Coles, O.D.

• All providers in East Grand Forks, MN
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.