NPIMap

Individual provider Active NPI

Bradley L Barth, MD

  • Emergency Medicine Physician
  • Stillwater, MN
National Provider Identifier
1912946138
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
41358 Issued in MN
Practice address
927 Churchill St W
Stillwater, MN 55082-6605
Phone
(651) 439-5330
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 41358 MN Primary
Emergency Medicine Physician 207P00000X 62662 WI

Addresses

Primary practice location

927 Churchill St W
Stillwater, MN 55082-6605

Mailing address

8170 33Rd Ave S
Bloomington, MN 55425-4516

Other practice location 1

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-3456

Other practice location 2

1575 Beam Ave
Maplewood, MN 55109-1126
Phone (651) 232-7348

Other practice location 3

405 Stageline Rd
Hudson, WI 54016-7848
Phone (715) 531-6000

Other practice location 4

535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071101000652 MN Practitioner - Emergency Medicine 6901993336 Reassigns benefits to 2 organizations
I20150129002316 WI Practitioner - Emergency Medicine 6901993336 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Minnesota Medical School, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeview Memorial Hospital Association, Inc.Group PAC ID 1951210855, 19 clinicians

Practice addresses (Care Compare)

927 Churchill W St
Stillwater, MN 55082-6605
Phone (651) 439-5330

Hospital & facility affiliations

  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066
  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41358MNMDEmergency Medicine Physician
62662WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Hospital, Inc. CurrentSince Sep 1, 2014 Accepting new patients
Lakeview Memorial Hospital Association Inc CurrentSince Jan 1, 2016 Accepting new patients
Lakeview Memorial Hospital Association Inc. Emergency Medicine CurrentSince Jan 1, 2016 Accepting new patients
Westfields Hospital, Inc. CurrentSince Jul 24, 2014 Accepting new patients
Westfields Hospital, Inc CurrentSince Jul 24, 2014 Accepting new patients
Regions Hospital Emergency Medicine CurrentSince Jan 1, 2014 Accepting new patients
Hudson Hospital, Inc. CurrentSince Sep 1, 2014 Accepting new patients
Regions Hospital CurrentSince Jan 1, 2014 Accepting new patients

Locations

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

927 Churchill St W
Stillwater, MN 55082
Phone (651) 430-4529

1500 Curve Crest Blvd W
Stillwater, MN 55082

921 Greeley St S
West Lakeland, MN 55082

405 Stageline Rd
Hudson, WI 54016
Phone (715) 531-6000

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

Organizations & group practices 11

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 10

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1912946138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 CHURCHILL ST W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826605",
            "telephone_number": "651-439-5330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "651-254-3456",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1575 Beam Ave",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091126",
            "country_code": "US",
            "telephone_number": "651-232-7348",
            "fax_number": "651-232-6665",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Stageline Rd",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540167848",
            "country_code": "US",
            "telephone_number": "715-531-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "New Richmond",
            "state": "WI",
            "postal_code": "540171449",
            "country_code": "US",
            "telephone_number": "715-243-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTH",
        "first_name": "BRADLEY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "41358",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "62662",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.