Individual provider Active NPI

Nicholas Coren Bradbury, M.D.

  • Vascular & Interventional Radiology Physician
  • Bismarck, ND
National Provider Identifier
1801110101
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
13303 Issued in ND
Practice address
310 N 10TH St
Bismarck, ND 58501-4516
Phone
(701) 530-7500
Fax
(701) 530-7484
NPI assigned
Mar 16, 2010
Last updated
Aug 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MT193226 PA
Vascular & Interventional Radiology Physician 2085R0204X 8614430-1205 UT
Vascular & Interventional Radiology Physician 2085R0204X 13303 ND Primary

Addresses

Primary practice location

310 N 10TH St
Bismarck, ND 58501-4516

Mailing address

PO Box 2698
Bismarck, ND 58502-2698
Phone (701) 530-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140811000570 ND Practitioner - Interventional Radiology 5597997759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Alexius Medical CenterGroup PAC ID 8426960865, 239 clinicians

Practice addresses (Care Compare)

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone (701) 530-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.48 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal22
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT193226PAMDDiagnostic Radiology Physician
13303NDMDVascular & Interventional Radiology Physician
8614430-1205UTMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Sep 12, 2015 Accepting new patients
St. Alexius Medical Center CurrentSince Sep 12, 2015 Accepting new patients
Missouri Basin Anesthesia, PLLC Past Accepting new patients

Locations

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

Interoperability endpoints

  • Direct secure messaging: nbradbury128329@achce.catholichealth.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1268697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1801110101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2698",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585022698",
            "telephone_number": "701-530-7500",
            "fax_number": "701-530-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N 10TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014516",
            "telephone_number": "701-530-7500",
            "fax_number": "701-530-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADBURY",
        "first_name": "NICHOLAS",
        "middle_name": "COREN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-16",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MT193226",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "8614430-1205",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "ND",
            "license": "13303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.