Bret M Danielson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

10241 Issued in MN

Practice address

30833 North Star Dr, Ste 1
Breezy Point, MN 56472-4407

Phone

(218) 568-4926

Fax

(218) 546-4400

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bret.danielson@811393367080964.direct.elationemr.com

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.

• Cuyuna Regional Medical Center

  • Family Medicine Physician
  • Longville, MN
  • NPI 1861414518

  MN

  Medicare reassignment
• Unity Family Healthcare

  • Orthopaedic Surgery Physician
  • Little Falls, MN
  • NPI 1326234006

  MN

  Medicare reassignment
• Cuyuna Regional Medical Center

  • Critical Access Hospital
  • Crosby, MN
  • NPI 1538143896
  NPD
• Cuyuna Regional Medical Center

  • Critical Access Hospital Clinic/Center
  • Crosby, MN
  • NPI 1639459282
  NPD
• Riverview Healthcare Association

  • Institutional Pharmacy
  • Crookston, MN
  • NPI 1083763650
  NPD
• Unity Family Healthcare

  • Clinic/Center
  • Randall, MN
  • NPI 1336359009
  NPD
• Unity Family Healthcare

  • Home Health Agency
  • Little Falls, MN
  • NPI 1952329047
  NPD
• Carrington Health Center

  • Rural Health Clinic/Center
  • New Rockford, ND
  • NPI 1801811666
  NPD (past)
• Fast Doc LLC

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1174307854
  NPD (past)
• Hans Bjellum MD PC

  • Urgent Care Clinic/Center
  • Fargo, ND
  • NPI 1841547387
  NPD (past)
• Union County Health Foundation

  • Federally Qualified Health Center (FQHC)
  • Alcester, SD
  • NPI 1578595062
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1366461873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EAST MAIN STREET",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "56441",
            "telephone_number": "218-546-7000",
            "fax_number": "218-546-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30833 NORTH STAR DR, STE 1",
            "city": "BREEZY POINT",
            "state": "MN",
            "postal_code": "564724407",
            "telephone_number": "218-568-4926",
            "fax_number": "218-546-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "BRET",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ND",
            "license": "PAC0351",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSND @ KULM",
            "identifier": "28514",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSND @ NAPOLEON",
            "identifier": "28515",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSND @ GACKLE",
            "identifier": "28516",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSND @ WISHEK",
            "identifier": "28513",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdanielson436403@ecxellian.direct.allina.com",
            "affiliation": "Y",
            "affiliationName": "Cuyuna Regional Medical Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bdanielson436403@excellian.direct.allina.com",
            "address_1": "320 E Main St",
            "city": "Crosby",
            "state": "MN",
            "country_code": "US",
            "postal_code": "564411645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdanielson436403@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDA/PDF/TXT",
            "address_1": "30833 North Star Dr, Ste 1",
            "city": "Breezy Point",
            "state": "MN",
            "country_code": "US",
            "postal_code": "564724407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bpoint Pharmacy Services LTD
• Jeevan Singh Dhouni, RPH
• Lisa K Iverson
• Starr Merie Jarvis, LAC.
• KQ Consulting, LLC
• Samantha Jo Miller

• All providers in Breezy Point, MN
• Medical Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.