Individual provider Active NPI

Brett Tupy

  • Contractor
  • Lakeville, MN
National Provider Identifier
1265096374
Registry record updated Apr 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
BC142754 Issued in MN
Practice address
7548 236TH St E
Lakeville, MN 55044-9813
Phone
(952) 226-3434
NPI assigned
Apr 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X BC142754 MN Primary

Addresses

Primary practice location

7548 236TH St E
Lakeville, MN 55044-9813

Mailing address

7548 236TH St E
Lakeville, MN 55044-9813
Phone (952) 226-3434

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BC142754MNMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1265096374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7548 236TH ST E",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449813",
            "telephone_number": "952-226-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7548 236TH ST E",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449813",
            "telephone_number": "952-226-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUPY",
        "first_name": "BRETT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "MN",
            "license": "BC142754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.