Individual provider Active NPI

Alyssa Lynn Brandt, MD

  • Surgery Physician
  • Minneapolis, MN
National Provider Identifier
1073073755
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
82151 Issued in MN
Practice address
420 Delaware St SE
MMC 195
Minneapolis, MN 55455
Phone
(612) 625-6483
NPI assigned
Mar 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 82151 MN Primary

Addresses

Primary practice location

420 Delaware St SE
MMC 195
Minneapolis, MN 55455

Mailing address

420 Delaware St SE
Minneapolis, MN 55455-0341

Other practice location 1

640 Jackson St
Saint Paul, MN 55101-2502
Phone (952) 967-7977

Other practice location 2

30 N 1900 E Rm 3B324
Salt Lake City, UT 84132-0002
Phone (801) 581-6803

Other names 1

  • Alyssa Brandt Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20200915001922 UT Order and Referring Only - General SurgeryPractitioner - General Surgery 3678991122

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1073073755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 195",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-625-6483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "640 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551012502",
            "country_code": "US",
            "telephone_number": "952-967-7977",
            "fax_number": "651-254-7990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 N 1900 E Rm 3B324",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320002",
            "country_code": "US",
            "telephone_number": "801-581-6803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "ALYSSA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "82151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "BRANDT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.