Individual provider Active NPI

Katherine Lynn Braski, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1326338120
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
64973 Issued in MN
Practice address
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone
(312) 813-6000
NPI assigned
Apr 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 8436339 UT
Neonatal-Perinatal Medicine Physician 2080N0001X 64973 MN Primary

Addresses

Primary practice location

2525 Chicago Ave
Minneapolis, MN 55404-4518

Mailing address

5901 Lincoln Drive
CBC-2-Rev/Pe
Edina, MN 55436-1611
Phone (952) 992-5624

Other practice location 1

100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (218) 310-4967

Other names 1

  • Katherine Lynn Haynes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190306002234 MN Practitioner - Pediatric Medicine 4880826734 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8436339UTMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care Current Accepting new patients
Childrens Health Care CurrentSince Apr 1, 2019 Accepting new patients
Childrens Health Care CurrentSince Apr 1, 2019 Accepting new patients
Allina Health System Past Accepting new patients

Locations

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

5901 Lincoln Dr
#2
Saint Louis Park, MN 55436
Phone (952) 992-5691

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1326338120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 LINCOLN DRIVE",
            "address_2": "CBC-2-REV/PE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554361611",
            "telephone_number": "952-992-5624",
            "fax_number": "952-992-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "312-813-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Mario Capecchi Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841131103",
            "country_code": "US",
            "telephone_number": "218-310-4967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRASKI",
        "first_name": "KATHERINE",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "UT",
            "license": "8436339",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MN",
            "license": "64973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HAYNES",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.