Individual provider Active NPI

Bradley James Mikaelian, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Colorado Springs, CO
National Provider Identifier
1861598682
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
47545 Issued in CO
Practice address
1400 E Boulder St
Suite 700
Colorado Springs, CO 80909-5533
Phone
(719) 635-7172
Fax
(719) 444-3759
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 223227 MA
Clinical Cardiac Electrophysiology Physician 207RC0001X 47545 CO Primary

Addresses

Primary practice location

1400 E Boulder St
Suite 700
Colorado Springs, CO 80909-5533

Mailing address

2695 Rocky Mountain Ave
Suite 150
Loveland, CO 80538-8702
Phone (970) 624-4443

Other identifiers 1

IdentifierTypeStateIssuer
64684041MedicaidCO

Other names 1

  • Bradley James Quiring Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20090414000541 CO Practitioner - Cardiac Electrophysiology 6002812955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Loyola University of Chicago, Stritch School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1400 E Boulder
Suite 2410 Pre Procedure Memorial
Colorado Springs, CO 80909-5533
Phone (719) 365-6525

1400 E Boulder St
Colorado Springs, CO 80909-5533

16420 W US Hwy 24
Hospital Medicine Pikes Peak
Woodland Park, CO 80863-8760
Phone (719) 365-1292

2500 Rocky Mountain Ave
Loveland, CO 80538-9004

328 S Bonaventure Ave
Suite 2 Uchmg Cardiology Trinidad
Trinidad, CO 81082-2086
Phone (719) 845-4880

4050 Briargate Pkwy
Colorado Springs, CO 80920-7815

4080 Briargate Pkwy
Colorado Springs, CO 80920-7815
Phone (719) 365-6800

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

5623 Pulpit Peak VW
Colorado Springs, CO 80918-3954
Phone (719) 365-1292

Hospital & facility affiliations

  • Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022
  • Uchealth Grandview Hospital Hospital, Colorado Springs, CO, CCN 060130
  • Prowers Medical Center Hospital, Lamar, CO, CCN 061323
  • Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020
  • Uchealth Pikes Peak Regional Hospital Hospital, Woodland Park, CO, CCN 061326

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47545COMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Dec 15, 2012 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Dec 15, 2012 Accepting new patients
Uch-MHS Past Accepting new patients
Uch-MHS Past Accepting new patients
Pikes Peak Cardiology a Professional LLP Past Accepting new patients
Memorial Health System Internal Medicine Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1400 E Boulder St
Ste 700
Colorado Springs, CO 80909
Phone (719) 365-7172

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

4110 Briargate Pkwy
Ste 400
Colorado Springs, CO 80920
Phone (719) 364-6550

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 6

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 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1861598682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "SUITE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388702",
            "telephone_number": "970-624-4443",
            "fax_number": "970-490-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E BOULDER ST",
            "address_2": "SUITE 700",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095533",
            "telephone_number": "719-635-7172",
            "fax_number": "719-444-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKAELIAN",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "223227",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CO",
            "license": "47545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64684041",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRADLEY",
            "last_name": "QUIRING",
            "middle_name": "JAMES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.