Individual provider Active NPI

Brady Perry Griffith, PA-C

  • Physician Assistant
  • Waconia, MN
National Provider Identifier
1700328689
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12320 Issued in MN
Practice address
500 S Maple St
Waconia, MN 55387-1752
Phone
(952) 442-2191
Fax
(952) 442-6537
NPI assigned
Nov 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 12320 MN
Physician Assistant 363A00000X 12320 MN Primary

Addresses

Primary practice location

500 S Maple St
Waconia, MN 55387-1752

Mailing address

8959 Partridge Rd
Saint Bonifacius, MN 55375-1320

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170207000673 MN Practitioner - Physician Assistant 5799068250 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

1000 W 140TH St
Unit 201
Burnsville, MN 55337-4833
Phone (952) 808-3000

3111 124TH Ave NW
Suite 200
Coon Rapids, MN 55433-4573
Phone (763) 427-7300

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000

820 Village Way
Waconia, MN 55387-4612

965 Prairie Ctr Dr
Eden Prairie, MN 55344-3671

Hospital & facility affiliations

  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
12320MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jul 24, 2023 Accepting new patients
Sibley Medical Center CurrentSince Feb 1, 2017 Accepting new patients
Ridgeview Medical Center CurrentSince Feb 1, 2017 Accepting new patients
Ridgeview Medical Center CurrentSince Feb 1, 2017 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jul 24, 2023 Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients

Locations

601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271

165 W Commerce Dr
Belle Plaine, MN 56011
Phone (952) 777-5661

5601 96th Ave N
Ste 200
Brooklyn Park, MN 55443
Phone (763) 786-9543

7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570

111 Hundertmark Rd
Ste 120
Chaska, MN 55318
Phone (952) 856-4001

916 Saint Peter Ave E
Delano, MN 55328
Phone (763) 972-9172

621 S 4th St
Le Sueur, MN 56058
Phone (507) 665-3375

9630 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 520-7580

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

820 Village Way
#200
Waconia, MN 55387

500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191

Organizations & group practices 8

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 2

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": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1700328689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8959 PARTRIDGE RD",
            "city": "SAINT BONIFACIUS",
            "state": "MN",
            "postal_code": "553751320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S MAPLE ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871752",
            "telephone_number": "952-442-2191",
            "fax_number": "952-442-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "BRADY",
        "middle_name": "PERRY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-09",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "12320",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.