Active NPI
Bradley Lemar Isaak, M.D.
- Ophthalmology Physician
- Mason City, IA
National Provider Identifier
1699883256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 22566
- Practice address
- 3121 4TH St SW
Mason City, IA 50401-1581 - Phone
- (641) 423-8861
- Fax
- (641) 423-0727
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 22566 | IA | Primary |
Addresses
Primary practice location
3121 4TH St SW
Mason City, IA 50401-1581
Mailing address
PO Box 1877
Mason City, IA 50402-1877
Phone (641) 423-8861
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0213223 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22566 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699883256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1877",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504021877",
"telephone_number": "641-423-8861",
"fax_number": "641-423-0727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3121 4TH ST SW",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504011581",
"telephone_number": "641-423-8861",
"fax_number": "641-423-0727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISAAK",
"first_name": "BRADLEY",
"middle_name": "LEMAR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IA",
"license": "22566",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0213223",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mason City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.