DAVID R BRADSHAW (MED, LP) – Psychologist, NPI 1093890782

DAVID R BRADSHAW (MED, LP) is a healthcare provider. based in Burnsville, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MED, LP. They hold a License No. LP3945 (MN). The NPI Number for DAVID R BRADSHAW (MED, LP) is 1093890782

Main info

Male
39 Years Of Experience
Accepts Medicare Assignment
Name
DAVID R BRADSHAW (MED, LP)
NPI
1093890782
Phone
(952) 892-7690
Address
14569 GRAND AVE
Enumeration Date
25 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9528927690100
Graduation Year
1987 (39 years ago)
PAC ID
2860646924
Group Practice PAC ID
2163525031
Professional Enrollment ID
I20240208003696
Address ID
MN553067012BU1751XWXXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

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Provider Addresses for DAVID R BRADSHAW (MED, LP)

  • Grand Avenue, Burnsville, Dakota County, Minnesota, 55337, United States

    SUITE 200

    BURNSVILLE, MN 553065729

    Phone: (952) 892-7690

    Fax: (952) 898-4930

    Mailing address matches the actual address.

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: 2024-02-08

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
I20240208003696IMental Health CounselorMNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55306)

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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: 2163525031View full group profile
NameSpecialtyState
Mental Health CounselorMN
Nurse PractitionerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Nurse PractitionerMN
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

How is DAVID R BRADSHAW (MED, LP) identified in CMS data?
CMS-hosted NPPES data lists DAVID R BRADSHAW (MED, LP) with NPI 1093890782.
Does the file indicate DAVID R BRADSHAW (MED, LP) is practicing under active NPI?
Directory data currently reports DAVID R BRADSHAW (MED, LP) as active.
What is DAVID R BRADSHAW (MED, LP)'s specialty?
The listing groups DAVID R BRADSHAW (MED, LP) with Psychologist. Clinical services aligned with this taxonomy classification.
Does DAVID R BRADSHAW (MED, LP) list a practice location?
Patients near Burnsville, Minnesota may find DAVID R BRADSHAW (MED, LP) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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