Individual provider Active NPI

Holly Brandenburg, DPT

  • Physical Therapist
  • Maplewood, MN
National Provider Identifier
1285412783
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13307 Issued in MN
Practice address
2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242
Phone
(651) 232-7800
NPI assigned
Sep 18, 2023
Last updated
Sep 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13307 MN Primary

Addresses

Primary practice location

2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242

Mailing address

2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231003000911 MN Practitioner - Physical Therapist in Private Practice 5496109985 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

3305 Central Park Village Dr
Suite 130
Eagan, MN 55121-7707
Phone (651) 406-8868

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2023 Accepting new patients
Healtheast Outpatient Services, LLC Physical Therapist CurrentSince Oct 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Oct 1, 2023 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

15650 Cedar Ave
Ste 160
Apple Valley, MN 55124
Phone (952) 997-4170

3305 Central Park Village Dr
Ste 130
Eagan, MN 55121
Phone (651) 406-8701

12000 Elm Creek Blvd N
Ste 120
Maple Grove, MN 55369
Phone (763) 420-9960

10961 Club West Pkwy
Ste 200
Minneapolis, MN 55449
Phone (763) 528-2987

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1285412783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091242",
            "telephone_number": "651-232-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDENBURG",
        "first_name": "HOLLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.