Individual provider Active NPI

Andrea Bruns, PA-C

  • Physician Assistant
  • Apple Valley, MN
National Provider Identifier
1417326778
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
15650 Cedar Ave
Apple Valley, MN 55124-7283
Phone
(952) 997-4100
NPI assigned
Sep 16, 2015
Last updated
Apr 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

15650 Cedar Ave
Apple Valley, MN 55124-7283

Mailing address

100 State Ave
Faribault, MN 55021-6337

Other practice location 1

100 State Ave
Faribault, MN 55021-6337
Phone (507) 334-3921

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202001597 MN Practitioner - Physician Assistant 7618277302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

15650 Cedar Ave
Apple Valley, MN 55124-7283
Phone (952) 997-4100

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (952) 914-1732

201 E Nicollet Blvd
Burnsville, MN 55337-5714
Phone (952) 892-2000

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-6000

600 W 98TH St
Bloomington, MN 55420-4773
Phone (952) 881-2651

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11932MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince May 11, 2018 Accepting new patients
Fairview Clinics CurrentSince May 11, 2018 Accepting new patients
Fairview Express Care CurrentSince May 16, 2021 Accepting new patients
Fairview Express Care CurrentSince May 16, 2021 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

15650 Cedar Ave
Apple Valley, MN 55124
Phone (952) 997-4100

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

Interoperability endpoints

  • Direct secure messaging: abruns320148@fairview.direct-ci.com

Organizations & group practices 7

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

Hospital & facility affiliations 2

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1417326778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STATE AVE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 CEDAR AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247283",
            "telephone_number": "952-997-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 State Ave",
            "address_purpose": "LOCATION",
            "city": "Faribault",
            "state": "MN",
            "postal_code": "550216337",
            "country_code": "US",
            "telephone_number": "507-334-3921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNS",
        "first_name": "ANDREA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.