BRADLEY TAIT GOETTL FNP
NPI 1740694454
Nurse Practitioner - Family in San Antonio, TX

Q: What is Bradley Goettl's NPI number?

The NPI number for Bradley Goettl is 1740694454. It was assigned to this individual provider in the NPPES registry on June 20, 2014.

Q: What is Bradley Goettl's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Goettl was last updated on September 27, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 20, 2014PECOS Enrolled

74.59/100

CMS Quality Rating

4502 MEDICAL DR, SAN ANTONIO, TX 78229(210) 358-2078(210) 358-1972 Get Directions Write a Review

NPPES record last updated: September 27, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Bradley Tait Goettl Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADLEY TAIT GOETTL FNP (NPI 1740694454) is an individual family provider in San Antonio, Texas, licensed in Texas (AP125858) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1740694454

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameBRADLEY TAIT GOETTLCredential: FNP

Location Address4502 MEDICAL DRSan Antonio, TX 78229-4402

Mailing Address7703 Floyd Curl DrSan Antonio, TX 78229-3901 · (210) 358-2078

Phone(210) 358-2078

Fax(210) 358-1972

Sole ProprietorNo

Enumeration DateJune 20, 2014

Last NPPES UpdateSeptember 27, 2016

✔ NPI 1740694454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in TX · AP125858✔ Licensed in WI · 6653-33

Also ListedEmergency Medical Technician, ParamedicTaxonomy 146L00000X · License 709205 (TX)

Also ListedRegistered Nurse · EmergencyTaxonomy 163WE0003X · License 766200 (TX)

4502 MEDICAL DR, San Antonio, TX 78229

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Other Identifiers 3

Medicaid339105407TX

Other339105408TX · Cshcn

Medicare UPIN365497YK00TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradley Tait Goettl Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78229 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.59/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

56.12

Promoting Interoperability

100

Improvement Activities

Cost

59.2

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDUARDO N. POLLONO MD

Internal Medicine (Cardiovascular Disease)