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Deactivated NPI 1568461739 Deactivated / Inactive NPI Male Practitioner

Dr. Bradley J. Wallum , MD

Specialist • Bellevue, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Bradley Wallum has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 19, 2005
NPI Deactivation Date April 01, 2019
Total Practice Duration ~14 Years of Practice (2005 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Bradley Wallum, MD was a registered Specialist practicing in Bellevue, WA. Throughout an active medical career spanning 14 years, Dr. Wallum provided care at the practice location at 2020 116TH AVE NE until profile deactivation on 2019-04-01.

Historical Medicare Part B clinical services included established patient outpatient office visit, new patient outpatient office visit, fine needle aspiration biopsy, first growth. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

2020 116th Ave Ne
Suite 150

Bellevue, WA 980043059

Telephone 4254539762
Fax 4254555953
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Bellevue, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 32.2 Yrs
State Avg: 35.4 Yrs
Regional Practice Density
116 Specialists

Practicing in Bellevue, WA (2751 Statewide)

Telehealth Adoption Rate
1.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
32.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
458 193 $180.00 $116.56
99213 Established patient office or other outpatient visit, typically 15 minutes
37 18 $115.00 $78.16
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
13 13 $260.00 $177.23
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
11 11 $70.00 $48.08

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License WA MD00021456

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Thomas Hamilton , MD

Internal Medicine - Endocrinology, Diabetes & Metabolism

NPI 1407802655

Doctor of Medicine (M.D.)

NPI 1629251970

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 01, 2019

Record deactivated on April 01, 2019

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2020 116TH AVE NE, SUITE 150, BELLEVUE, WA 980043059 (Tel: 4254539762)

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Updated Business Mailing Address July 08, 2007

Registered at 4332 193RD AVE SE, ISSAQUAH, WA 980279704 (Tel: 4256499817)

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Provider Name / Credentials Updated July 08, 2007

Recorded as BRADLEY WALLUM, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #MD00021456 in WA)

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Initial NPI Registration & Enumeration July 19, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1568461739
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 19, 2005
Last Update: July 08, 2007
Deactivation Date: April 01, 2019

Mailing Address

4332 193rd Ave Se

Issaquah, WA 980279704

Phone: 4256499817

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.