BRADFORD WISNOUSKY (DO) – Emergency Medicine Physician, NPI 1093777500

BRADFORD WISNOUSKY (DO) is a healthcare provider. based in Cedar rapids, Iowa. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. 3300 (IA). The NPI Number for BRADFORD WISNOUSKY (DO) is 1093777500

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
BRADFORD WISNOUSKY (DO)
NPI
1093777500
Phone
(319) 369-4505
Address
PO BOX 5610
Enumeration Date
3 April 2006
Last Update Date
30 October 2007

Doctor Profile

Medical School Name
DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Secondary Phone
3193390300
Graduation Year
1997 (29 years ago)
PAC ID
5597787515
Group Practice PAC ID
6901231810
Professional Enrollment ID
I20060407000056
Address ID
IA522452633IO500XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

483 EMERGENCY MEDICINE in IA

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Provider Addresses for BRADFORD WISNOUSKY (DO)

  • PO BOX 5610

    CEDAR RAPIDS, IA 524065610

    Phone: (319) 369-4505

    Fax: (319) 369-4677

    Type: Mailing

  • 701, 10th Street Southeast, MedQuarter, Cedar Rapids, Linn County, Iowa, 52403, United States

    CEDAR RAPIDS, IA 524031251

    Phone: (319) 398-6297

    Fax: (319) 398-6249

    Type: Location

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: 2006-04-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060407000056IEmergency MedicineIATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making289282$0
99284Emergency department visit with moderate level of medical decision making115113$0
99291Critical care, first 30-74 minutes5656$0
99283Emergency department visit with low level of medical decision making3636$0
View full utilization report →

Insurance plans in this area (ZIP 52406)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6901231810View full group profile
NameSpecialtyState
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineMI
Emergency MedicineIA
Emergency MedicineMO
Emergency MedicineIA
Nurse PractitionerIA
Emergency MedicineTX
Emergency MedicineIA
Emergency MedicineIA

Reviews

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Frequently asked questions

How is BRADFORD WISNOUSKY (DO) identified in CMS data?
CMS-hosted NPPES data lists BRADFORD WISNOUSKY (DO) with NPI 1093777500.
Is BRADFORD WISNOUSKY (DO) still practicing?
BRADFORD WISNOUSKY (DO) is currently listed as active in the public NPI registry.
What is BRADFORD WISNOUSKY (DO)'s specialty?
The listing groups BRADFORD WISNOUSKY (DO) with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Does BRADFORD WISNOUSKY (DO) list a practice location?
Patients near Cedar Rapids, Iowa may find BRADFORD WISNOUSKY (DO) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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