Individual provider Active NPI

Bryce Cole Holmgren, M.D.

  • Anesthesiology Physician
  • Sartell, MN
National Provider Identifier
1366854226
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A153895 Issued in CA
Practice address
166 19TH St S Ste 101
Sartell, MN 56377-2154
Phone
(320) 230-7788
Fax
(320) 230-7789
NPI assigned
May 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 66143 MN
Anesthesiology Physician 207L00000X 9408317 KS
Anesthesiology Physician 207L00000X A153895 CA Primary

Addresses

Primary practice location

166 19TH St S Ste 101
Sartell, MN 56377-2154

Mailing address

166 19TH St S Ste 101
Sartell, MN 56377-2154
Phone (320) 230-7788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210218002220 CA Practitioner - Anesthesiology 7315243862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Minnesota Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

2105 Forest Ave
San Jose, CA 95128-1425
Phone (408) 947-2500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A153895CAMDAnesthesiology Physician
9408317KSMDAnesthesiology Physician
66143MNMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Jan 25, 2021 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Jan 25, 2021 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

Interoperability endpoints

  • Direct secure messaging: bholmgren170443@santaclaravalley.direct-ci.net

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1366854226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 19TH ST S STE 101",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772154",
            "telephone_number": "320-230-7788",
            "fax_number": "320-230-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 19TH ST S STE 101",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772154",
            "telephone_number": "320-230-7788",
            "fax_number": "320-230-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMGREN",
        "first_name": "BRYCE",
        "middle_name": "COLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "66143",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "9408317",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A153895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.