Sean Thomas O'Brien, MD
Individual provider Active NPI Pediatrics Physician · Rushmore, MN
NPI 1134411192 · NPPES record last updated Jul 24, 2015
Key facts
- NPI
- 1134411192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 59208 (MN)
- Practice address
- 119 S Thompson Ave
Rushmore, MN 56168-9674 - Phone
- (651) 408-4980
- NPI assigned
- May 10, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- University of Minnesota Medical School, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fairview Health Services
Practice addresses (Care Compare)
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-3000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150625001929 | MN | Practitioner - Pediatric Medicine | 0042437618 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59208 | MN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current | Accepting new patients | |
| Fairview Clinics | Current |
Accepting new patients | |
| Fairview Health Services | Current |
Accepting new patients | |
| Fairview Health Services | Current | Accepting new patients | |
| Fairview Express Care | Current |
Accepting new patients | |
| University of Minnesota Physicians | Current |
Accepting new patients | |
| University of Minnesota Physicians | Current | Accepting new patients | |
| Sanford Health of Northern Minnesota | Current | Accepting new patients | |
| Fairview Express Care | Current |
Accepting new patients | |
| Fairview Health Services | Past | Accepting new patients | |
| Maple Grove Hospital Corporation | Past | Accepting new patients | |
| Cardiothoracic Surgery Clinic of North Ms | Past | Accepting new patients |
Locations
1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020
1300 Anne St NW
Bemidji, MN 56601
Phone (218) 333-5794
909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383
2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838
720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 59208 | MN | Yes |
Addresses
Primary practice location
119 S Thompson Ave
Rushmore, MN 56168-9674
Mailing address
119 S Thompson Ave
Rushmore, MN 56168-9674
Phone (651) 408-4980
Other providers in Rushmore, MN
All providers in Rushmore, MN · Pediatrics Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.