Individual provider Active NPI

Brianna L. Sucik, PA-C

  • Physician Assistant
  • St Louis Park, MN
National Provider Identifier
1235319377
Registry record updated Dec 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3850 Park Nicollet Blvd
Urgent Care-SLP
St Louis Park, MN 55416-2527
Phone
(952) 993-3025
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MD Primary

Addresses

Primary practice location

3850 Park Nicollet Blvd
Urgent Care-SLP
St Louis Park, MN 55416-2527

Mailing address

3800 Park Nicollet Blvd
Attn: Katlyn Johnson, Credentialing
St Louis Park, MN 55416-2527
Phone (952) 883-6355

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
I20150511001497 MN Practitioner - Physician Assistant 7810067907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

300 Lake Dr E
Chanhassen, MN 55317-9302
Phone (952) 993-4300

4155 County Rd 101
Plymouth, MN 55446-2307
Phone (952) 993-8900

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Feb 4, 2015 Accepting new patients
Park Nicollet Clinic CurrentSince Feb 4, 2015 Accepting new patients

Locations

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

4155 County Road 101 N
Plymouth, MN 55446
Phone (952) 977-3000

3800 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 993-1000

3850 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 883-1000

Organizations & group practices 3

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 6

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": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419638400000",
    "number": "1235319377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 PARK NICOLLET BLVD",
            "address_2": "ATTN: KATLYN JOHNSON, CREDENTIALING",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-883-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 PARK NICOLLET BLVD",
            "address_2": "URGENT CARE-SLP",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162527",
            "telephone_number": "952-993-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCIK",
        "first_name": "BRIANNA",
        "middle_name": "L.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2014-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.