Active NPI
Brandon Wiberg, DO
- Diagnostic Radiology Physician
- Roseville, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 81925
- Practice address
- 2355 Hwy 36 W
Ste. 100
Roseville, MN 55113 - Phone
- (651) 292-2000
- NPI assigned
- Mar 26, 2020
- Last updated
- Jul 7, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 82182-21 | WI | |
| Diagnostic Radiology Physician | 2085R0202X | 81925 | MN | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 02008369A | IN | |
| Diagnostic Radiology Physician | 2085R0202X | 24009 | ND |
Addresses
Primary practice location
2355 Hwy 36 W
Ste. 100
Roseville, MN 55113
Mailing address
2355 Hwy 36 W
Ste. 100
Roseville, MN 55113
Phone (651) 292-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, WI, MN, ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Arizona College of Osteopathic Medicine Mid Western University, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02008369A | IN | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Current | Accepting new patients | |
| Indiana University Radiology Associates, Inc. | Diagnostic Radiology | Current | Accepting new patients |
| Suburban Imaging, LLC | Current | Accepting new patients |
Locations
5924 Reliable Pkwy
Chicago, IL 60686
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
1701 Senate Blvd
#C6
Indianapolis, IN 46202
Phone (317) 962-9000
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
550 University Blvd
#641
Indianapolis, IN 46202
Phone (317) 274-0010
8990 Springbrook Dr NW
Ste 140
Minneapolis, MN 55433
Phone (763) 792-1900
2355 Highway 36 W
Ste 100
Saint Paul, MN 55113
Phone (651) 292-0000
Interoperability endpoints
- bwiberg@direct.iuhealth.org
- bwiberg140042@direct.eskenazihealth.edu
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Diagnostic Radiology Physician
- Indianapolis, IN
- NPI 1336192665
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Radiology Clinic/Center
- Roseville, MN
- NPI 1427008937
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba IU Health Paoli
- Critical Access Hospital
- Paoli, IN
- NPI 1912984451
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1275160426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2355 HWY 36 W",
"address_2": "STE. 100",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "55113",
"telephone_number": "651-292-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2355 HWY 36 W",
"address_2": "STE. 100",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "55113",
"telephone_number": "651-292-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIBERG",
"first_name": "BRANDON",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-26",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WI",
"license": "82182-21",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MN",
"license": "81925",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IN",
"license": "02008369A",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "ND",
"license": "24009",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.