Active NPI
Kathleen Dwyer Brooks, M.D.
- Family Medicine Physician
- Minneapolis, MN
National Provider Identifier
1245266279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 26201
- Practice address
- Umphysicians Broadway Family Medicine
1020 West Broadway
Minneapolis, MN 55411 - Phone
- (612) 302-8200
- Fax
- (612) 302-8275
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26201 | MN | Primary |
Addresses
Primary practice location
Umphysicians Broadway Family Medicine
1020 West Broadway
Minneapolis, MN 55411
Mailing address
Umphysicians Broadway Family Medicine
1020 West Broadway
Minneapolis, MN 55411
Phone (612) 302-8200
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0144245 | Medicaid | MT | |
| 0549006 | Other | MN | PREFERRED ONE |
| 21592 | Other | MN | ARAZ |
| 01-20983 | Other | MN | MEDICA CHOICE |
| 109315 | Other | MN | UCARE |
| HP31006 | Other | MN | HEALTHPARTNERS |
| 251P1BR | Other | MN | BCBS |
| 34065600 | Medicaid | WI | |
| 0592204 | Medicaid | IA | |
| 511K0BR | Other | MN | BCBS BFM |
| A070 | Other | MN | CHAMPUS |
| 01-12519 | Other | MN | MEDICA PRIMARY |
| 01-21776 | Other | MN | MEDICA CHOICE&PRIM BFM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26201 | MN | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Minnesota Physicians | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1245266279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "UMPHYSICIANS BROADWAY FAMILY MEDICINE",
"address_2": "1020 WEST BROADWAY",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55411",
"telephone_number": "612-302-8200",
"fax_number": "612-302-8275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UMPHYSICIANS BROADWAY FAMILY MEDICINE",
"address_2": "1020 WEST BROADWAY",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55411",
"telephone_number": "612-302-8200",
"fax_number": "612-302-8275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "KATHLEEN",
"middle_name": "DWYER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "26201",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0144245",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "0549006",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "21592",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE",
"identifier": "01-20983",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "109315",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP31006",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "251P1BR",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34065600",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0592204",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS BFM",
"identifier": "511K0BR",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "A070",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA PRIMARY",
"identifier": "01-12519",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE&PRIM BFM",
"identifier": "01-21776",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.