Individual provider Active NPI

Brent Wolford, M.D.

  • Diagnostic Radiology Physician
  • Clive, IA
National Provider Identifier
1942567243
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
CDR.0001325 Issued in CO
Practice address
12368 Stratford Dr Ste 300
Clive, IA 50325-8149
Phone
(515) 226-8408
Fax
(515) 226-8408
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD-44322 IA
Diagnostic Radiology Physician 2085R0202X CDR.0001325 CO Primary

Addresses

Primary practice location

12368 Stratford Dr Ste 300
Clive, IA 50325-8149

Mailing address

777 Bannock St
Denver, CO 80204-4597
Phone (303) 643-6494

Other practice location 1

777 Bannock St
Denver, CO 80204-4507
Phone (303) 643-6494 ext. 9

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170608000874 IA Practitioner - Diagnostic Radiology 6002184462 Reassigns benefits to 4 organizations
I20220614000805 CO Practitioner - Diagnostic Radiology 6002184462 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Radiology P CGroup PAC ID 2264323468, 37 clinicians
Iowa Diagnostic Imaging and Procedure Center, L CGroup PAC ID 1658263546, 36 clinicians
Montrose Memorial Hospital, IncGroup PAC ID 1658272992, 148 clinicians

Practice addresses (Care Compare)

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-6171

1221 Pleasant St
Suite 350
Des Moines, IA 50309-1420
Phone (515) 226-9810

12368 Stratford Dr
Suite 300
Clive, IA 50325-8149
Phone (515) 228-9810

1660 60TH St
West Des Moines, IA 50266-7700
Phone (515) 343-1800

300 Sioux Valley Dr
Cherokee, IA 51012-1205
Phone (712) 225-5101

700 E University Ave
Unity Point Hosp
Des Moines, IA 50316-2302
Phone (515) 263-5612

800 S 3Rd St
Montrose Regional Health Radiology
Montrose, CO 81401-4212
Phone (970) 252-2691

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
81.64 of 100Reported as group
Quality
78.11
Improvement activities
40
Cost
78.95

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CDR.0001325COMDDiagnostic Radiology Physician
MD-44322IAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Jun 1, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jun 1, 2022 Accepting new patients
Des Moines University Osteopathic Medical Center Diagnostic Radiology CurrentSince Oct 1, 2018 Accepting new patients
Des Moines University Osteopathic Medical Center CurrentSince Oct 1, 2018 Accepting new patients
Trinity Regional Medical Center CurrentSince Dec 28, 2018 Accepting new patients
Iowa Physicians Clinic Medical Foundation Past Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

700 E University Ave
Des Moines, IA 50316
Phone (515) 263-5120

3200 Grand Ave
Fl 5
Des Moines, IA 50312
Phone (515) 271-1707

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

1555 Hull Ave
Des Moines, IA 50316
Phone (515) 262-5639

3200 Grand Ave
Des Moines, IA 50312
Phone (515) 271-1700

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

625 L St
Fort Dodge, IA 50501
Phone (515) 574-3015

710 N 12th St
Guthrie Ctr, IA 50115
Phone (641) 332-2201

1000 15th St N
Humboldt, IA 50548
Phone (515) 332-4200

606 NW 7th St
Pocahontas, IA 50574
Phone (712) 335-3501

211 Highland Ave
Sac City, IA 50583
Phone (712) 662-7105

1525 W 5th St
Storm Lake, IA 50588
Phone (712) 732-4030

1660 60th St
West Des Moines, IA 50266
Phone (515) 241-2250

Interoperability endpoints

  • Direct secure messaging: bwolford266681@direct.dhha.org

Organizations & group practices 9

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 7

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1942567243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-643-6494",
            "fax_number": "303-602-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12368 STRATFORD DR STE 300",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258149",
            "telephone_number": "515-226-8408",
            "fax_number": "515-226-8408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Bannock St",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044507",
            "country_code": "US",
            "telephone_number": "303-643-6494 x9",
            "fax_number": "303-602-4168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFORD",
        "first_name": "BRENT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "MD-44322",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "CDR.0001325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

Verify at the official NPI Registry.