NPIMap

Individual provider Active NPI

Brandon Joseph Kelly, M.D.

  • Orthopaedic Surgery Physician
  • Eagan, MN
National Provider Identifier
1194259143
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
73871 Issued in MN
Practice address
2620 Eagan Woods Dr Ste 100
Eagan, MN 55121-1138
Phone
(651) 968-5201
Fax
(651) 968-5903
NPI assigned
Apr 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 73871 MN Primary

Addresses

Primary practice location

2620 Eagan Woods Dr Ste 100
Eagan, MN 55121-1138

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220726003364 CA Practitioner - Orthopedic Surgery 4880963875 Reassigns benefits to 2 organizations
I20230621000331 MN Practitioner - Orthopedic Surgery 4880963875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

2620 Eagan Woods Dr
Eagan, MN 55121-1138
Phone (651) 968-5201

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement25
Knee replacement20

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco Orthopaedic Surgery CurrentSince Jul 15, 2022 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jul 15, 2022 Accepting new patients
Summit Orthopedics LTD Orthopaedic Surgery CurrentSince Aug 1, 2023 Accepting new patients
University of California San Francisco Current Accepting new patients
Summit Orthopedics, LTD Orthopaedic Surgery CurrentSince Aug 1, 2023 Accepting new patients
University of California San Francisco CurrentSince Jul 15, 2022 Accepting new patients
UCSF Medical Group Business Services Orthopaedic Surgery CurrentSince Jul 15, 2022 Accepting new patients
Summit Orthopedics LTD Current Accepting new patients
Ilbnc, P.a. Past Accepting new patients

Locations

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

1500 Owens St
San Francisco, CA 94158
Phone (415) 353-2808

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

2620 Eagan Woods Dr
Ste 100
Eagan, MN 55121
Phone (651) 968-5230

17210 Kenyon Ave
Lakeville, MN 55044
Phone (651) 968-5960

2450 Riverside Ave
#R200
Minneapolis, MN 55454
Phone (612) 273-1177

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300

2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 968-5142

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5801

Interoperability endpoints

  • Direct secure messaging: bkelly236947@direct-ucsfmedicalcenter.org
  • Direct secure messaging: brandonkelly@sol.allscriptsdirect.net

Organizations & group practices 10

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 9

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1194259143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EAGAN WOODS DR STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211138",
            "telephone_number": "651-968-5201",
            "fax_number": "651-968-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRANDON",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-17",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "73871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.