NPIMap

Individual provider Active NPI

Brett W Nyholm, M.D.

  • Nephrology Physician
  • Brooklyn Center, MN
National Provider Identifier
1255305355
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
44788 Issued in MN
Practice address
6200 Shingle Creek Pkwy
Suite 250
Brooklyn Center, MN 55430-2128
Phone
(763) 544-0696
NPI assigned
Feb 15, 2006
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 44788 MN Primary

Addresses

Primary practice location

6200 Shingle Creek Pkwy
Suite 250
Brooklyn Center, MN 55430-2128

Mailing address

6200 Shingle Creek Pkwy
Suite 260
Brooklyn Center, MN 55430-2128
Phone (763) 561-5349

Other identifiers 8

IdentifierTypeStateIssuer
809652000MedicaidMN
143225C028OtherMNU-CARE
3100381OtherMNMEDICA
HP62024OtherMNHEALTHPARTNERS
123D3NYOtherMNBCBS
960931050396OtherMNPREFERRED ONE
020OtherMNAMERICA'S PPO
34779200MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bnyholm95887@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040824000684 MN Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Neurology 6103890256 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Neurology
Education
University of Minnesota Medical School, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regency Hospital of Minneapolis, LLCGroup PAC ID 0345203840, 22 clinicians
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians
Kidney Specialists of Minnesota, PAGroup PAC ID 5092616029, 33 clinicians

Practice addresses (Care Compare)

1300 Hidden Lakes Pkwy
Golden Valley, MN 55422-4286
Phone (763) 588-2750

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-5200

6200 Shingle Creek Pkwy
Suite 250
Brooklyn Center, MN 55430-2107
Phone (763) 544-0696

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Kidney Specialists of Minnesota, PA Nephrology CurrentSince Aug 1, 2007 Accepting new patients
Regency Hospital of Minneapolis, LLC CurrentSince Jul 14, 2018 Accepting new patients
North Memorial Health Care CurrentSince Nov 1, 2017 Accepting new patients
North Memorial Health Care Current Accepting new patients
Ilbnc, P.a. Past Accepting new patients
Bio-Medical Applications of Minnesota, Inc. PastSince Oct 1, 2008 Accepting new patients

Locations

1700 Highway 25 N
Hanover, MN 55313
Phone (763) 682-1313

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

1300 Hidden Lakes Pkwy
Minneapolis, MN 55422
Phone (763) 588-2750

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

6200 Shingle Creek Pkwy
Ste 250
Minneapolis, MN 55430
Phone (612) 823-8001

6200 Shingle Creek Pkwy
Ste 260
Minneapolis, MN 55430
Phone (763) 544-0696

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

210 9th St SE
Rochester, MN 55904
Phone (507) 529-6616

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

Interoperability endpoints

  • Direct secure messaging: bnyholm16496@direct.acumenmd.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 40

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 40

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1255305355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SHINGLE CREEK PKWY",
            "address_2": "SUITE 260",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302128",
            "telephone_number": "763-561-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SHINGLE CREEK PKWY",
            "address_2": "SUITE 250",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302128",
            "telephone_number": "763-544-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYHOLM",
        "first_name": "BRETT",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MN",
            "license": "44788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "809652000",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U-CARE",
            "identifier": "143225C028",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "3100381",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP62024",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "123D3NY",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "960931050396",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "020",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34779200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bnyholm95887@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "6200 Shingle Creek Pkwy",
            "address_2": "Suite 250",
            "city": "Brooklyn Center",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554302128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brooklyn Center, MN

Sources for this page

Verify at the official NPI Registry.