Michael J Brickner, MD
Individual provider Active NPI Diagnostic Radiology Physician · Brainerd, MN
NPI 1154536696 · NPPES record last updated Mar 14, 2013
Key facts
- NPI
- 1154536696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 51063 (MN)
- Practice address
- 2019 S 6TH St
Brainerd, MN 56401-4528 - Phone
- (218) 822-4242
- Fax
- (218) 822-3758
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 35
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Creighton University School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aitkin Community Hospital Inc
Mille Lacs Health System
Lakewood Health System
Practice addresses (Care Compare)
200 Bunker Hill Dr
Aitkin, MN 56431-1865
Phone (218) 927-2121
200 Elm St N
Onamia, MN 56359-7901
Phone (320) 532-2750
49725 County
Suite 83
Staples, MN 56479-5280
Phone (218) 894-1515
Hospital & facility affiliations
- Lakewood Health System
- Delta County Memorial Hospital
- Riverwood Healthcare Center
- Mille Lacs Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN, CO
- 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 |
|---|---|---|---|---|
| I20080827000723 | MN | Practitioner - Diagnostic Radiology | 2466528419 | Reassigns benefits to 7 organizations |
| I20240410002026 | CO | Practitioner - Diagnostic Radiology | 2466528419 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23701 | NE | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakewood Health System | Current |
Accepting new patients | |
| Brainerd Medical Center Inc | Current | Accepting new patients | |
| Lakewood Health System | Current |
Accepting new patients | |
| Mille Lacs Health System | Current |
Accepting new patients | |
| Mountain Radiology, Inc | Diagnostic Radiology | Current |
Accepting new patients |
| Mille Lacs Health System | Current | Accepting new patients | |
| Aitkin Community Hospital, Inc. | Current |
Accepting new patients | |
| Mille Lacs Health System | Current |
Accepting new patients | |
| Mille Lacs Health System | Current | Accepting new patients | |
| Aitkin Community Hospital, Inc. | Current |
Accepting new patients |
Locations
750 Hospital Loop
Craig, CO 81625
Phone (970) 824-9411
600 Russell St
Craig, CO 81625
Phone (970) 824-3252
1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033
750 Wellington Ave
Grand Junction, CO 81501
Phone (970) 244-2457
2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009
200 Bunker Hill Dr
Aitkin, MN 56431
Phone (218) 927-2121
523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394
13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920
2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880
27378 State Highway 18
Garrison, MN 56450
Phone (320) 692-5599
200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750
49725 County 83
Staples, MN 56479
Phone (218) 894-1033
Interoperability endpoints
- mbrickner626035@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 103736 | MN | |
| Diagnostic Radiology Physician | 2085R0202X | 23701 | NE | |
| Diagnostic Radiology Physician | 2085R0202X | 51063 | MN | Yes |
Addresses
Primary practice location
2019 S 6TH St
Brainerd, MN 56401-4528
Mailing address
2019 S 6TH St
Brainerd, MN 56401-4528
Phone (218) 822-4242
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00649009 | Other | MN | RAILROAD MEDICARE |
Other providers in Brainerd, MN
- Colleen Bratney
- Stacy Lynette Brazier
- Breath of Life Adult Day SVC
- Blaine Anthony Brecht
- Susan Carol Brennan
- Bridges to Home Health Care
- Brighter Horizons Adult Day Center
- Kristina Marie Britton
- Caroline Brix
- Janet Brown
All providers in Brainerd, MN · Diagnostic Radiology 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 Mar 14, 2013. 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.