| Dr Bradley Scott Shore, MD | |
|
4901 Wills St, Metairie, LA 70006-1132 | |
| (952) 595-1100 | |
| (952) 942-3361 |
| Full Name | Dr Bradley Scott Shore |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 31 Years |
| Location | 4901 Wills St, Metairie, Louisiana |
| 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 |
|---|---|---|---|
| 1427053347 | NPI | - | NPPES |
| 102090529 | Medicaid | PA | |
| 1948063 | Medicaid | LA | |
| 1481823 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 022372 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Avala | Covington, LA | Hospital |
| Ochsner Clinic Foundation | New orleans, LA | Hospital |
| St Tammany Parish Hospital | Covington, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fairway Medical Center Llc | 6406815687 | 5 |
| Diagnostic Imaging Services | 7618872102 | 23 |
| Entity Name | Diagnostic Imaging Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699793166 PECOS PAC ID: 7618872102 Enrollment ID: O20031208000109 |
| Entity Name | Fairway Medical Center Llc |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1265023170 PECOS PAC ID: 6406815687 Enrollment ID: O20210224001527 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Bradley Scott Shore, MD 11995 Singletree Ln, Suite 500, Eden Prairie, MN 55344-5347 Ph: (952) 595-1100 | Dr Bradley Scott Shore, MD 4901 Wills St, Metairie, LA 70006-1132 Ph: (952) 595-1100 |
Dr. Sean T O'brien, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4200 Houma Blvd, Metairie, LA 70006 Phone: 504-503-4314 Fax: 504-456-8125 | |
Dr. John N Joslyn, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4200 Houma Blvd, Radiology Department, Metairie, LA 70006 Phone: 504-454-4133 Fax: 504-456-8125 | |
Dr. Mary E. Lobrano, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4200 Houma Blvd, Metairie, LA 70006 Phone: 504-454-4133 Fax: 504-456-8125 | |
Paul D Monsour, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 4204 Houma Blvd, Suite 211, Metairie, LA 70006 Phone: 504-454-1727 Fax: 504-455-4857 | |
Dr. David Joseph St. Germain Jr., M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 4200 Houma Blvd, Metairie, LA 70006 Phone: 504-503-4314 Fax: 504-456-8125 | |
Dr. John C Sandoz, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 4200 Houma Blvd, Metairie, LA 70006 Phone: 504-455-4133 Fax: 504-456-8125 |