Individual provider Active NPI

Bradley Daniel Chmielewski, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Plymouth, MN
National Provider Identifier
1063618023
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
49124 Issued in MN
Practice address
2800 Campus Dr Ste 10
Plymouth, MN 55441-8812
Phone
(763) 559-2171
NPI assigned
Jun 26, 2007
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 49124 MN Primary
Pulmonary Disease Physician 207RP1001X 49124 MN

Addresses

Primary practice location

2800 Campus Dr Ste 10
Plymouth, MN 55441-8812

Mailing address

2800 Campus Dr Ste 10
Plymouth, MN 55441-8812
Phone (763) 559-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090714000631 MN Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 8628120128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
University of Minnesota Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians
Respiratory Consultants PAGroup PAC ID 6204736853, 22 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-4897

3366 Oakdale Ave N
Suite 401
Robbinsdale, MN 55422-2986
Phone (763) 520-2940

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Respiratory Consultants PA Pulmonary Disease CurrentSince Sep 13, 2023 Accepting new patients
North Memorial Health Care CurrentSince Jul 1, 2023 Accepting new patients
North Memorial Health Care CurrentSince Jul 1, 2023 Accepting new patients
North Memorial Health Care Current Accepting new patients

Locations

2800 Campus Dr
Ste 10
Plymouth, MN 55441
Phone (763) 398-4400

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

3366 Oakdale Ave N
Ste 401
Robbinsdale, MN 55422
Phone (763) 398-6383

3366 Oakdale Ave N
Ste 605
Robbinsdale, MN 55422
Phone (612) 561-5986

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1063618023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CAMPUS DR STE 10",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554418812",
            "telephone_number": "763-559-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CAMPUS DR STE 10",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554418812",
            "telephone_number": "763-559-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHMIELEWSKI",
        "first_name": "BRADLEY",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "49124",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "49124",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.