Brooke Elizabeth Pettinelli, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R179144-4 Issued in MN

Practice address

1101 9TH St N
Duluth Clinic-Virginia
Virginia, MN 55792-2329

Phone

(218) 741-0150

NPI assigned

Sep 16, 2010

Last updated

Sep 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Brooke Elizabeth Fischer Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Pines Medical CenterGroup PAC ID 3870565641, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Northern Pines Medical Center Hospital, Aurora, MN, CCN 241340

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern Pines Medical Center

  dba Essentia Health Northern Pines

  • Critical Access Hospital
  • Aurora, MN
  • NPI 1639278609
  Medicare reassignment Care Compare group NPD
• Deer River Healthcare Center, Inc.

  dba Essentia Health Deer River

  • Critical Access Hospital
  • Deer River, MN
  • NPI 1225049018
  Medicare reassignment NPD
• Essentia Health Virginia, LLC

  dba Essentia Health Virginia

  • General Acute Care Hospital
  • Virginia, MN
  • NPI 1083617120
  Medicare reassignment NPD
• The Duluth Clinic LTD

  dba Essentia Health Cloquet Clinic

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment NPD
• Essentia Health Moose Lake

  • Critical Access Hospital
  • Moose Lake, MN
  • NPI 1154959880
  Medicare reassignment
• Deer River Healthcare Center, Inc

  dba Essentia Health Deer River Clinic

  • Critical Access Hospital Clinic/Center
  • Deer River, MN
  • NPI 1518904887
  NPD
• Deer River Healthcare Center, Inc.

  dba Essentia Health Deer River

  • Medicare Defined Swing Bed Hospital Unit
  • Deer River, MN
  • NPI 1215041199
  NPD
• Essentia Health Moose Lake

  dba Essentia Health Moose Lake Clinic

  • Critical Access Hospital Clinic/Center
  • Moose Lake, MN
  • NPI 1275102048
  NPD
• Essentia Health Virginia, LLC

  dba Essentia Health Babbitt Clinic

  • Rural Health Clinic/Center
  • Babbitt, MN
  • NPI 1326595646
  NPD
• Northern Pines Medical Center

  dba Essentia Health Northern Pines Clinic

  • Rural Health Clinic/Center
  • Aurora, MN
  • NPI 1285183046
  NPD
• Northern Pines Medical Center

  dba Essentia Health Northern Pines Clinic

  • Critical Access Hospital Clinic/Center
  • Aurora, MN
  • NPI 1881954147
  NPD
• The Duluth Clinic, LTD.

  dba Essentia Health Hinckley Pharmacy

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD

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

• Northern Pines Medical Center

  dba Essentia Health Northern Pines

  • Critical Access Hospital
  • Aurora, MN
  • NPI 1639278609
  Care Compare affiliation
• Northern Pines Medical Center

  dba Essentia Health Northern Pines Clinic

  • Critical Access Hospital Clinic/Center
  • Aurora, MN
  • NPI 1881954147
  Care Compare affiliation

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1093023772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 9TH ST N",
            "address_2": "DULUTH CLINIC-VIRGINIA",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922329",
            "telephone_number": "218-741-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 9TH ST N",
            "address_2": "DULUTH CLINIC-VIRGINIA",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922329",
            "telephone_number": "218-741-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINELLI",
        "first_name": "BROOKE",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "R179144-4",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "R179144-4",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "FISCHER",
            "middle_name": "ELIZABETH",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mahryn G Perpich
• Joshua Ervin Peterson-Sell
• Carol Camille Peterson
• Gidget Peterson, PA-C
• Maggie Mae Peterson
• Elana Sue Pfeifer
• Plesha Chiropractic, P.a.
• Brian James Plesha, DC
• Jacklyn Marie Plesha
• Plum Tree Dental

• Family Nurse Practitioner in Virginia, MN
• Providers in Virginia, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.