Brad A Mouse, DO | |
1101 Nw Pamela Blvd, Suite A, Grain Valley, MO 64029-7841 | |
(816) 295-1606 | |
(816) 295-1606 |
Full Name | Brad A Mouse |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 39 Years |
Location | 1101 Nw Pamela Blvd, Grain Valley, Missouri |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588604979 | NPI | - | NPPES |
18960020 | Other | CFU BCBS | |
13384041 | Other | BCBS PROVIDER NUMBER | |
080148316 | Other | MO | RR MEDICARE |
481159444 | Other | TAX ID | |
2057742 | Other | AETNA | |
1588604979 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | R9G82 (Missouri) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Lukes Hospital Of Kansas City | Kansas city, MO | Hospital |
Centerpoint Medical Center | Independence, MO | Hospital |
Entity Name | Diamond Medical Care, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770978413 PECOS PAC ID: 9739493081 Enrollment ID: O20150731014643 |
Mailing Address | Practice Location Address |
---|---|
Brad A Mouse, DO 1101 Nw Pamela Blvd, Suite A, Grain Valley, MO 64029-7841 Ph: (816) 295-1606 | Brad A Mouse, DO 1101 Nw Pamela Blvd, Suite A, Grain Valley, MO 64029-7841 Ph: (816) 295-1606 |
Randall Lee Culbertson, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 29508 E Pink Hill Rd, Grain Valley, MO 64029 Phone: 816-251-4724 Fax: 816-246-4850 | |
Rachel E Gordon, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1439 S Minter Way, Grain Valley, MO 64029 Phone: 816-404-6797 |