Benjamin Dean Brenner, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3766 Issued in MN

Practice address

6625 Lyndale Ave S Ste 300
Richfield, MN 55423-2491

Phone

(612) 243-8999

Fax

(612) 869-3473

NPI assigned

Jul 14, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• In House Senior Services, LLC

  • Primary Podiatric Medicine Podiatrist
  • Richfield, MN
  • NPI 1083962294

  Optometrist

  NPD

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1013205871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 300",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232491",
            "telephone_number": "612-243-8999",
            "fax_number": "612-869-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 300",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232491",
            "telephone_number": "612-243-8999",
            "fax_number": "612-869-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "BENJAMIN",
        "middle_name": "DEAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013205871",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Braden Bowker, DDS
• Michael Wayne Bowser, DC, LAC
• Jennifer Brady-Johnson, OTR/L
• Gina Brady, OTR/L
• Amy Brendel, M.D
• Gabrielle Jean Brewington
• Brian T Ross LMFT LLC
• Bright Paths Autism Inc.
• Kayla Brinkman
• David P Brockway, MD

• Optometrist in Richfield, MN
• Providers in Richfield, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.