Individual provider Active NPI

Bradley Kranendonk, M.D.

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
National Provider Identifier
1770530909
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301503245 Issued in MI
Practice address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone
(616) 363-7339
Fax
(616) 361-5828
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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 4301503245 MI Primary
Diagnostic Radiology Physician 2085R0202X 40564 MN

Addresses

Primary practice location

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746

Mailing address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7339

Other practice location 1

4801 W 81st St
Suite 108
Bloomington, MN 55437-1111
Phone (952) 837-9700

Other practice location 2

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone (763) 780-9155

Other practice location 3

250 Thompson St
Saint Paul, MN 55102-2370
Phone (651) 292-2000

Other identifiers 1

IdentifierTypeStateIssuer
557025500MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI, MI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20100525000858 MN Practitioner - Diagnostic Radiology 4688579329 Reassigns benefits to 5 organizations
I20200324002944 WI Practitioner - Diagnostic Radiology 4688579329 Reassigns benefits to 1 organization
I20201028001491 MI Practitioner - Diagnostic Radiology 4688579329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Radiology Services PCGroup PAC ID 4284546516, 252 clinicians

Practice addresses (Care Compare)

3264 N Evergreen Dr NE
Suite 100
Grand Rapids, MI 49525-9746
Phone (616) 363-7272

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Corewell Health Ludington Hospital Hospital, Ludington, MI, CCN 230110
  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301503245MIMDDiagnostic Radiology Physician
40564MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Radiology Services PC Diagnostic Radiology CurrentSince Dec 1, 2020 Accepting new patients
Allina Health System CurrentSince Mar 1, 2019 Accepting new patients
Allina Health System CurrentSince Mar 1, 2019 Accepting new patients
Altru Health System CurrentSince Jun 1, 2020 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Mar 1, 2020 Accepting new patients
Allina Health System Current Accepting new patients
Altru Health System CurrentSince Jun 1, 2020 Accepting new patients
Altru Health System Current Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Jul 15, 2019 Accepting new patients
Fairview Express Care CurrentSince Jul 15, 2019 Accepting new patients
Consulting Radiologists, LTD Diagnostic Radiology PastSince Mar 1, 2019 Accepting new patients

Locations

3264 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 391-6001

3264 N Evergreen Dr NE
Ste 100
Grand Rapids, MI 49525

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

6545 France Ave S
Ste 471
Edina, MN 55435
Phone (952) 836-3558

6545 France Ave S
Ste 125
Edina, MN 55435
Phone (952) 405-2777

2945 Hazelwood St
Ste 110
Maplewood, MN 55109

9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

2355 Highway 36 W
Ste 100
Saint Paul, MN 55113
Phone (651) 292-0000

166 4th St E
Saint Paul, MN 55101
Phone (651) 292-2009

166 4th St E
Ste 100
Saint Paul, MN 55101

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

Organizations & group practices 17

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 17

Hospital & facility affiliations 8

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1770530909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7339",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7339",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 W 81st St",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554371111",
            "country_code": "US",
            "telephone_number": "952-837-9700",
            "fax_number": "952-837-9701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9055 Springbrook Dr NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554335841",
            "country_code": "US",
            "telephone_number": "763-780-9155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "250 Thompson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551022370",
            "country_code": "US",
            "telephone_number": "651-292-2000",
            "fax_number": "651-292-2136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRANENDONK",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301503245",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "40564",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "557025500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.