Individual provider Active NPI

Breanna Marie Opdahl, NP

  • Adult Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1164098521
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
8080 Issued in MN
Practice address
800 E 28TH St
Minneapolis, MN 55407-3723
Phone
(612) 863-7553
NPI assigned
May 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8080 MN
Adult Health Nurse Practitioner 363LA2200X 8080 MN Primary

Addresses

Primary practice location

800 E 28TH St
Minneapolis, MN 55407-3723

Mailing address

800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 863-0200

Other names 1

  • Breanna Marie Flicek Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bopdahl270395@excellian.direct.allina.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210623003270 MN Practitioner - Nurse Practitioner 5991106262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians

Practice addresses (Care Compare)

110105 Pioneer TRL W
Chaska, MN 55318-2680
Phone (952) 361-5800

560 S Maple St
Suite 100
Waconia, MN 55387-1753
Phone (952) 442-6006

6545 France Ave S
Suite 210
Edina, MN 55435-2281
Phone (952) 928-2900

Hospital & facility affiliations

  • Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

Merit-based Incentive Payment System (MIPS)

Final score
89.19 of 100Reported as apm
Quality
72.34
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Oncology Hematology, PA Adult Health CurrentSince Sep 26, 2022 Accepting new patients
Minnesota Oncology Hematology PA CurrentSince Sep 26, 2022 Accepting new patients
Allina Health System Past Accepting new patients
Minnesota Oncology Hematology PA Nurse Practitioner PastSince Jan 14, 2024 Accepting new patients

Locations

1175 Paysphere Cir
Chicago, IL 60674

675 E Nicollet Blvd
Ste 100
Burnsville, MN 55337
Phone (952) 435-8516

110105 Pioneer Trl W
Chaska, MN 55318
Phone (952) 361-5800

10150 Niagara Ln N
#100
Maple Grove, MN 55369
Phone (763) 220-1316

6545 France Ave S
Ste 210
Minneapolis, MN 55435
Phone (952) 928-2900

910 E 26th St
Ste 100200
Minneapolis, MN 55404
Phone (612) 884-6300

11850 Blackfoot St NW
Ste 100
Minneapolis, MN 55433
Phone (763) 712-2100

480 Osborne Rd NE
Ste 220
Minneapolis, MN 55432
Phone (763) 786-1620

2805 Campus Dr
Ste 105
Plymouth, MN 55441
Phone (763) 519-7440

1580 Beam Ave
Saint Paul, MN 55109
Phone (651) 255-8480

2550 University Ave W
Ste 105N
Saint Paul, MN 55114
Phone (651) 602-5335

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

2550 University Ave W
Ste 110N
Saint Paul, MN 55114
Phone (651) 602-5309

560 S Maple St
Ste 100
Waconia, MN 55387
Phone (952) 442-6006

6025 Lake Rd
Ste 110
Woodbury, MN 55125
Phone (651) 735-7414

Interoperability endpoints

  • Direct secure messaging: bopdahl270395@excellian.direct.allina.com
  • Direct secure messaging: breanna.opdahl@moh.ikm.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1164098521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-0200",
            "fax_number": "612-262-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPDAHL",
        "first_name": "BREANNA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8080",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "8080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bopdahl270395@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "800 E 28th St",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554073723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BREANNA",
            "last_name": "FLICEK",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.