DR. BRADLEY DEE MANGUM (FNP-BC, DC) – Family Nurse Practitioner, NPI 1235465147
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,802 NURSE PRACTITIONER in ID
Provider Addresses for DR. BRADLEY DEE MANGUM (FNP-BC, DC)
267 N CANYON DR
MEDICAL PLAZA
GOODING, ID 833305500
Phone: (208) 934-4446
Fax: (208) 934-4442
Type: Mailing
267 N Canyon Dr
Medical Plaza
Gooding, ID 833305500
Phone: (208) 934-4446
Fax: (208) 934-4442
Type: Location
559 W WASHINGTON ST
BURNS, OR 977201441
Phone: (541) 573-2074
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-09-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130214000449 | I | Nurse Practitioner | WY | TBD |
| I20150925001155 | I | Nurse Practitioner | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 129 | 20 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 67 | 46 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 19 | 18 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 83330)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | WY | |
| Emergency Medicine | WY | |
| - | WY | |
| A N E S T H E S I O L O G Y | UT | |
| Family Practice | WY | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | ID | |
| Physician Assistant | WA | |
| Emergency Medicine | WY | |
| Family Practice | WY | |
| Physician Assistant | IA |
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