Individual provider Active NPI

Erin Bravo, M.D.

  • Diagnostic Radiology Physician
  • Madison, WI
National Provider Identifier
1912294653
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
60569 Issued in WI
Practice address
600 Highland Ave # H4831
Madison, WI 53792-0001
Phone
(608) 263-8340
Fax
(608) 263-0682
NPI assigned
Jul 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 60569 WI Primary

Addresses

Primary practice location

600 Highland Ave # H4831
Madison, WI 53792-0001

Mailing address

15601 Dallas Pkwy Ste 500
Addison, TX 75001-6021
Phone (469) 398-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190911002145 AZ Practitioner - Diagnostic Radiology 3375766173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Creighton University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11220 N Tatum Blvd
Suite 105
Phoenix, AZ 85028-1629
Phone (602) 493-0204

1661 E Camelback Rd
Suite 140
Phoenix, AZ 85016-3957
Phone (602) 234-2601

18699 N 67TH Ave
Suite 110
Glendale, AZ 85308-7141
Phone (623) 218-7700

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60569WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ben-Ora Hansen & Vanesian Imaging LTD Diagnostic Radiology CurrentSince Sep 1, 2019 Accepting new patients
Ben-Ora, Hansen & Vanesian Imaging Past Accepting new patients
Ben-Ora Hansen & Vanesian Imaging Past Accepting new patients
Ben-Ora, Hansen, & Vanesian Imaging Past Accepting new patients

Locations

2081 W Frye Rd
Ste 110
Chandler, AZ 85224
Phone (480) 499-9101

18699 N 67th Ave
Ste 110
Glendale, AZ 85308
Phone (623) 218-7700

11220 N Tatum Blvd
Ste 105
Phoenix, AZ 85028
Phone (602) 234-2601

1661 E Camelback Rd
Ste 140
Phoenix, AZ 85016
Phone (602) 234-2601

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1912294653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15601 DALLAS PKWY STE 500",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750016021",
            "telephone_number": "469-398-4100",
            "fax_number": "469-398-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHLAND AVE # H4831",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537920001",
            "telephone_number": "608-263-8340",
            "fax_number": "608-263-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "ERIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-01",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "60569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.