NPIMap

Individual provider Active NPI

Benjamin Keith Brooks, M.D.

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
National Provider Identifier
1366479115
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
18981 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
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 7841494-1205 UT
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X 7841494-1205 UT
Diagnostic Radiology Physician 2085R0202X RS2005-0324 NM
Diagnostic Radiology Physician 2085R0202X 18981 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
Enrolled in UT, NM, NV, TN, WI5 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20110622000037 UT Practitioner - Diagnostic Radiology 8123175106 Reassigns benefits to 1 organization
I20161216000715 NM Practitioner - Diagnostic Radiology 8123175106 Reassigns benefits to 2 organizations
I20200207001172 NV Practitioner - Diagnostic Radiology 8123175106 Reassigns benefits to 2 organizations
I20220208000319 TN Practitioner - Diagnostic Radiology 8123175106 Reassigns benefits to 9 organizations
I20240924000945 WI Practitioner - Diagnostic Radiology 8123175106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Albuquerque PAGroup PAC ID 2860304482, 103 clinicians
SMB Radiology P aGroup PAC ID 9234136060, 22 clinicians

Practice addresses (Care Compare)

229 Gillette Dr
Franklin, TN 37069-4115
Phone (505) 332-6900

4411 The 25 Way NE
Suite 150
Albuquerque, NM 87109-5888
Phone (505) 332-5827

Hospital & facility affiliations

  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Memorial Hospital Biloxi Hospital, Biloxi, MS, CCN 250007
  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021
  • Plains Regional Medical Center Hospital, Clovis, NM, CCN 320022
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

Merit-based Incentive Payment System (MIPS)

Final score
89.28 of 100Reported as group
Quality
90
Improvement activities
40
Cost
77.05

Merit-based Incentive Payment System (MIPS)

Final score
76.35 of 100Reported as group
Quality
72.18
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.41 of 100Reported as group
Quality
91.07
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RS2005-0324NMMDDiagnostic Radiology Physician
18981NVMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMB Radiology P a Diagnostic Radiology CurrentSince Sep 15, 2024 Accepting new patients
St. George Radiology Inc. Diagnostic Radiology CurrentSince Jun 15, 2011 Accepting new patients
Nol, LLC Body Imaging CurrentSince Apr 1, 2022 Accepting new patients
Radiology Associates of Albuquerque, PA Diagnostic Radiology CurrentSince Jan 1, 2017 Accepting new patients
Premier Radiology Wisconsin, LLC Diagnostic Radiology CurrentSince Jun 30, 2022 Accepting new patients
Clarksville Imaging Center LLC Diagnostic Neuroimaging CurrentSince Apr 1, 2022 Accepting new patients
Adi Radiology PC Body Imaging CurrentSince Apr 1, 2022 Accepting new patients
Advanced Imaging LLC Diagnostic Radiology CurrentSince Jan 1, 2017 Accepting new patients
Radiology Specialists LTD Marasso-Miller Diagnostic Radiology CurrentSince Aug 1, 2020 Accepting new patients
Wisconsin Radiology Specialists, S C CurrentSince Nov 1, 2022 Accepting new patients
Zia Health Center PastSince Sep 4, 2011 Accepting new patients

Locations

14231 Seaway Rd
Ste 5003
Gulfport, MS 39503
Phone (228) 864-4392

4411 The 25 Way NE
Ste 150
Albuquerque, NM 87109
Phone (505) 332-5800

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

2320 Wilma Rudolph Blvd
Clarksville, TN 37040
Phone (931) 645-1564

3012 Business Park Cir
Ste 100
Goodlettsville, TN 37072
Phone (615) 239-2046

1210 Briarville Rd
Bldg F602
Madison, TN 37115
Phone (615) 773-7237

1840 Medical Center Pkwy
Murfreesboro, TN 37129
Phone (615) 848-0488

28 White Bridge Pike
Ste 104
Nashville, TN 37205

28 White Bridge Pike
Ste 111
Nashville, TN 37205
Phone (615) 986-6153

2323 Crestmoor Rd
Nashville, TN 37215

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1308 E 900 S
Ste C
St George, UT 84790
Phone (435) 673-2301

10180 Washington Ave
Mount Pleasant, WI 53177
Phone (414) 769-4040

Organizations & group practices 12

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.

Hospital & facility affiliations 64

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1366479115",
    "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": "BROOKS",
        "first_name": "BENJAMIN",
        "middle_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "UT",
            "license": "7841494-1205",
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "UT",
            "license": "7841494-1205",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "RS2005-0324",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "18981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.