Individual provider Active NPI

Brian Burgoyne, MD

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
National Provider Identifier
1356375695
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
6698 Issued in NV
Practice address
11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X MD441623 PA
Diagnostic Radiology Physician 2085R0202X MD441623 PA
Diagnostic Radiology Physician 2085R0202X MD00029456 WA
Diagnostic Radiology Physician 2085R0202X 6698 NV Primary

Addresses

Primary practice location

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Mailing address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD441623PAMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince May 29, 2017 Accepting new patients
Alameda Health System Current Accepting new patients
Alameda Health System CurrentSince Dec 22, 2010 Accepting new patients
San Carlos Apache Healthcare Corporation Current Accepting new patients
Alameda Health System CurrentSince Dec 22, 2010 Accepting new patients
Swedish Medical Center-Radia Issaquah Imaging Center LLC Diagnostic Radiology Past Accepting new patients
Swedish First Hill Diagnostic Imaging, LLC Diagnostic Radiology Past Accepting new patients
Evergreen Radia LLC Diagnostic Radiology Past Accepting new patients
Swedish Radia Imaging Center at Edmonds LLC Diagnostic Radiology Past Accepting new patients
Pueblo Medical Imaging, LLC Neuroradiology PastSince Dec 16, 1998 Accepting new patients
Potomac Radiology & Imaging Associates Inc Diagnostic Radiology Past Accepting new patients
Public Hospital District No 4 King County Washington Past Accepting new patients
Everett Radia LLC Diagnostic Radiology Past Accepting new patients
California Cancer Specialists Medical Group Inc Past Accepting new patients
J Paul Wiesner & Associates Chartered Neuroradiology PastSince Nov 3, 2019 Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients
City of Hope Medical Foundation Past Accepting new patients
Radia Inc P S Diagnostic Radiology Past Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1356375695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGOYNE",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "MD441623",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD441623",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD00029456",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "6698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.