Individual provider Active NPI

Andrew J Van Bruggen, DO

  • Otolaryngology Physician
  • Eagan, MN
National Provider Identifier
1003337809
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
69733 Issued in MN
Practice address
845 Vikings Pkwy Ste B
Eagan, MN 55121-1139
Phone
(888) 938-3838
Fax
(888) 919-1083
NPI assigned
Jun 30, 2017
Last updated
Oct 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 77450-21 WI
Otolaryngology Physician 207Y00000X 69733 MN Primary

Addresses

Primary practice location

845 Vikings Pkwy Ste B
Eagan, MN 55121-1139

Mailing address

10001 W Innovation Dr Ste 200
Milwaukee, WI 53226-4851
Phone (888) 938-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220919003014 MN Practitioner - Otolaryngology 1951786490 Reassigns benefits to 1 organization
I20221006002427 WI Practitioner - Otolaryngology 1951786490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Institutes LLCGroup PAC ID 4880928761, 12 clinicians

Practice addresses (Care Compare)

9325 Upland LN N
Suite 200
Maple Grove, MN 55369-4443
Phone (888) 938-3838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2017018862MOMDOtolaryngology Physician
77450WIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Ear Nose & Throat Specialists, SC CurrentSince Sep 30, 2022 Accepting new patients
Advanced Ear Nose & Throat Specialists, SC Otolaryngology CurrentSince Sep 30, 2022 Accepting new patients
Ear Institutes, LLC Otolaryngology CurrentSince Sep 30, 2022 Accepting new patients

Locations

845 Vikings Pkwy
Ste B
Eagan, MN 55121
Phone (651) 650-0500

6640 Shady Oak Rd
Ste 255
Eden Prairie, MN 55344

9325 Upland Ln N
Ste 200
Maple Grove, MN 55369

4365 Pheasant Ridge Dr NE
Ste 106
Minneapolis, MN 55449
Phone (763) 296-3277

8401 Seasons Pkwy
Ste 300
Woodbury, MN 55125

247 S Nicolet Rd
Appleton, WI 54914

2654 S Oneida St
Stop 102
Green Bay, WI 54304

10610 N Port Washington Rd
Mequon, WI 53092
Phone (262) 923-7879

500 W Drexel Ave
Ste 300
Oak Creek, WI 53154

10001 W Innovation Dr
Ste 200
Wauwatosa, WI 53226

2885 N Mayfair Rd
Wauwatosa, WI 53222
Phone (414) 615-7048

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792368000000",
    "number": "1003337809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 W INNOVATION DR STE 200",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264851",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 VIKINGS PKWY STE B",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211139",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BRUGGEN",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WI",
            "license": "77450-21",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MN",
            "license": "69733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.