NPIMap

Individual provider Active NPI

Stace Todd Bradshaw, M.D.

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
National Provider Identifier
1760472138
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
H9816 Issued in TX
Practice address
11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M-2194 GU
Diagnostic Radiology Physician 2085R0202X H9816 TX Primary

Addresses

Primary practice location

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Mailing address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GU2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051116000310 TX Practitioner - Diagnostic Radiology 9335183664 Reassigns benefits to 4 organizations
I20191115000823 GU Practitioner - Diagnostic Radiology 9335183664 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Baylor College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Imaging LLCGroup PAC ID 2860451648, 15 clinicians
Guam X-RayGroup PAC ID 8123180742, 33 clinicians

Practice addresses (Care Compare)

Dallas, TX 75225
Phone (800) 841-4236

633 Gov Carlos Camacho Rd
Suite 210
Tamuning, GU 96913
Phone (671) 649-1001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.28 of 100Reported as group
Quality
90
Improvement activities
40
Cost
77.05

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Quality
90
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
88.81 of 100Reported as group
Quality
83.57
Improvement activities
40
Cost
76.16

Merit-based Incentive Payment System (MIPS)

Final score
93.26 of 100Reported as group
Quality
100
Improvement activities
40
Cost
72.03

Merit-based Incentive Payment System (MIPS)

Final score
65.1 of 100Reported as group
Quality
100
Promoting interoperability
0
Improvement activities
30
Cost
79.51

Merit-based Incentive Payment System (MIPS)

Final score
79.22 of 100Reported as group
Quality
78.84
Improvement activities
40
Cost
61.61

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Guam Memorial Hospital CurrentSince May 12, 2020 Accepting new patients
Btdi JV LLP CurrentSince Nov 1, 2020 Accepting new patients
American Radiology Consultants PLLC Diagnostic Radiology CurrentSince Nov 30, 2020 Accepting new patients
Guam X-Ray Diagnostic Radiology CurrentSince Sep 10, 2019 Accepting new patients
Radiology Associates of Albuquerque, PA Diagnostic Radiology CurrentSince Jun 1, 2023 Accepting new patients
Advanced Imaging LLC Diagnostic Radiology CurrentSince Jun 19, 2023 Accepting new patients
Guam Healthcare Development Incorporated CurrentSince Jan 7, 2021 Accepting new patients
Btdi JV LLP CurrentSince Nov 1, 2020 Accepting new patients
Btdi JV LLP CurrentSince Nov 1, 2020 Accepting new patients
Btdi JV LLP CurrentSince Nov 1, 2020 Accepting new patients
Guam Memorial Hospital CurrentSince May 12, 2020 Accepting new patients
Southwest Medical Imaging PA Diagnostic Radiology CurrentSince May 1, 2011 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Advanced Imaging LLC Past Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

633 Gov Carlos G Camacho Rd
Ste 210
Tamuning, GU 96913
Phone (671) 649-1001

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

4411 The 25 Way NE
Ste 150
Albuquerque, NM 87109
Phone (505) 332-5800

3500 Gaston Ave
Dallas, TX 75246

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

1901 Grandview Ave
El Paso, TX 79902
Phone (915) 544-6750

1300 N 4th St
Longview, TX 75601
Phone (903) 757-2122

4214 Andrews Hwy
Ste 103
Midland, TX 79703
Phone (432) 221-1301

3550 NE Loop 286
Paris, TX 75460
Phone (903) 785-0031

200 N Virginia St
Terrell, TX 75160
Phone 97255174007500

2400 N Interstate Highway 35 E
Waxahachie, TX 75165
Phone (469) 843-4000

907 Foster Ln
Weatherford, TX 76086
Phone (817) 596-0637

1700 W State Highway 6
Woodway, TX 76712
Phone (254) 399-0741

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1760472138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "STACE",
        "middle_name": "TODD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GU",
            "license": "M-2194",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "H9816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.