Individual provider Active NPI

Brandon Wiberg, DO

  • Diagnostic Radiology Physician
  • Roseville, MN
National Provider Identifier
1275160426
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
81925 Issued in MN
Practice address
2355 Hwy 36 W
Ste. 100
Roseville, MN 55113
Phone
(651) 292-2000
NPI assigned
Mar 26, 2020
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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, ND4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20250515003379 IN Practitioner - Diagnostic Radiology 2466970116 Reassigns benefits to 2 organizations
I20260610000867 WI Practitioner - Diagnostic Radiology 2466970116
I20260610002918 MN Practitioner - Diagnostic Radiology 2466970116
I20260618003780 ND Practitioner - Diagnostic Radiology 2466970116

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
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Indiana University Radiology Associates IncGroup PAC ID 7315922267, 213 clinicians

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

LicenseStateTypeSpecialty
02008369AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients
Indiana University Radiology Associates, Inc. Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Suburban Imaging, LLC CurrentSince Aug 1, 2026 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

  • Direct secure messaging: bwiberg@direct.iuhealth.org
  • Direct secure messaging: 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.

Hospital & facility affiliations 1

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": "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

Verify at the official NPI Registry.