DR. BRAD L WYNN D.O.
NPI 1902033608
Family Medicine in Rupert, ID

Q: What is Brad Wynn's NPI number?

The NPI number for Brad Wynn is 1902033608. It was assigned to this individual provider in the NPPES registry on June 19, 2009.

Q: What is Brad Wynn's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Brad Wynn was last updated on August 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 19, 2009PECOS EnrolledAccepts Medicare Assignment

1308 8TH ST STE 1, RUPERT, ID 83350(208) 436-4322(208) 436-1312 Get Directions Write a Review

NPPES record last updated: August 25, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 25, 2023, Jan 2, 2017 (2 updates tracked since 2017).

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About Dr. Brad L Wynn D.o. NPPES

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

DR. BRAD L WYNN D.O. (NPI 1902033608) is an individual family medicine provider in Rupert, Idaho, licensed in Idaho (O-0676) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with St Lukes Magic Valley Medical Center, and maintains a secondary practice location in Rupert.

NPPES Registry Identity

NPI1902033608

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. BRAD L WYNNCredential: D.O.

Location Address1308 8TH ST STE 1Rupert, ID 83350-1535

Mailing Address1224 8th StreetRupert, ID 83350-1527 · (208) 434-4236 · Fax (208) 436-6038

Phone(208) 436-4322

Fax(208) 436-1312

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJune 19, 2009

Last NPPES UpdateAugust 25, 20232 updates tracked since enumeration

NPPES CertifiedAugust 25, 2023

✔ NPI 1902033608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in ID · O-0676

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1308 8TH ST STE 1, Rupert, ID 83350

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Secondary Practice Location 1

Location 11224 8th StreetRUPERT, ID 83350-1527 · Phone (208) 434-4236 · Fax (208) 436-6038

Other Identifiers 1

Medicaid1902033608ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Brad L Wynn D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446400683

PECOS Enrollment IDI20121023000781

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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Lukes Magic Valley Medical Center

Acute Care Hospitals · Twin Falls, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130002

Location801 Pole Line Road WestTwin Falls, ID 83301 · Twin Falls County

Emergency services Birthing friendly

Minidoka Memorial Hospital

Critical Access Hospitals · Rupert, ID

OwnershipGovernment - Local

CMS Certification Number131319

Location1224 8th StreetRupert, ID 83350 · Minidoka County

Emergency services

Cassia Regional Hospital

Critical Access Hospitals · Burley, ID

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number131326

Location1501 Hiland AvenueBurley, ID 83318 · Cassia County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83350 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

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

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.

Referred Medical Equipment & Supplies CMS DME claims 14

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

4 suppliers21 claims69 services$6.40 avg. paid by Medicare

Tubing with integrated heating element for use with positive airway pressure device A4604

DME-Other DME · category DE001N

1 supplier15 claims15 services$43.65 avg. paid by Medicare

Full face mask used with positive airway pressure device, each A7030

DME-Other DME · category DE001N

2 suppliers24 claims24 services$109.67 avg. paid by Medicare

Face mask interface, replacement for full face mask, each A7031

DME-Other DME · category DE001N

2 suppliers21 claims56 services$41.73 avg. paid by Medicare

Headgear used with positive airway pressure device A7035

DME-Other DME · category DE001N

2 suppliers18 claims18 services$23.67 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

2 suppliers29 claims162 services$2.98 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

ALEKSANDR DOROSHKIN MD

Family Medicine