Brent R Bullis, M.D.
Individual provider Active NPI Diagnostic Radiology Physician · Mankato, MN
NPI 1831140441 · NPPES record last updated Feb 22, 2022
Key facts
- NPI
- 1831140441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 39741 (MN)
- Practice address
- Mayo Clinic Health System Mankato
1025 Marsh St
Mankato, MN 56001 - Phone
- (507) 625-4031
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 33
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- University of Minnesota Medical School, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mayo Clinic Health System-Southwest Minnesota Region
Mayo Clinic Health System-St James
Mayo Clinic Health System-Fairmont
Practice addresses (Care Compare)
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031
1101 Moulton and Parsons Dr
Saint James, MN 56081-5550
Phone (507) 375-3261
800 Medical Ctr Dr
Fairmont, MN 56031-4575
Phone (507) 238-8555
Hospital & facility affiliations
- Mayo Clinic Health System - Mankato
- Mayo Clinic Health System - Fairmont
- Mayo Clinic Health System New Prague
- Mayo Clinic Health System - Waseca
- Mayo Clinic Health System St. James
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040130000405 | MN | Practitioner - Diagnostic Radiology | 8123921715 | Reassigns benefits to 16 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
Locations
404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285
701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700
7595 Anagram Dr
Eden Prairie, MN 55344
Phone (612) 573-2214
3955 Parklawn Ave
Ste 100
Edina, MN 55435
Phone (952) 285-3722
800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100
265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200
500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321
1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623
9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155
7505 Metro Blvd
Ste 400
Minneapolis, MN 55439
Phone 61257322002246
920 E 28th St
Ste 610
Minneapolis, MN 55407
Phone (612) 863-6900
7373 France Ave S
Ste 202
Minneapolis, MN 55435
Phone (952) 835-1311
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
920 E 28th St
Ste 240
Minneapolis, MN 55407
Phone (612) 863-3850
2828 Chicago Ave
Ste 200
Minneapolis, MN 55407
Phone (612) 879-1502
3601 Minnesota Dr
Ste 200
Minneapolis, MN 55435
Phone (952) 992-5691
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
2800 Chicago Ave
Ste 250
Minneapolis, MN 55407
Phone (612) 863-4096
301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431
200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850
1650 4th St SE
Rochester, MN 55904
Phone (507) 285-8485
1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261
8170 Old Carriage Ct
Ste 100
Shakopee, MN 55379
Phone (952) 428-3600
501 State St N
Waseca, MN 56093
Phone (507) 835-1210
825 Mankato Ave
Winona, MN 55987
Phone (507) 454-4925
Interoperability endpoints
- bbullis1688119@ehrdirect.mayoclinicmsg.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 39741 | MN | Yes |
Addresses
Primary practice location
Mayo Clinic Health System Mankato
1025 Marsh St
Mankato, MN 56001
Mailing address
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bbullis1688119@ehrdirect.mayoclinicmsg.org | Direct |
Other providers in Mankato, MN
- Michele Buckley
- Baylie Alexis Bueltel
- Alyssa Jean Buffington
- Angela L H Buffington
- Brandon Robert Bukowski
- Emily Burchett
- Noah Keith Burger-Edwards
- Douglas Wilford Burgess
- Teagan A Burgess
- Paige Burke
All providers in Mankato, MN · Diagnostic Radiology Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.