Active NPI
Mark L Brancel, MD
- Family Medicine Physician
- Apple Valley, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 31706
- Practice address
- 15290 Pennock LN
Apple Valley, MN 55124-7163 - Phone
- (952) 853-8800
- Fax
- (952) 431-6966
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 66991-20 | WI | |
| Family Medicine Physician | 207Q00000X | 31706 | MN | Primary |
Addresses
Primary practice location
15290 Pennock LN
Apple Valley, MN 55124-7163
Mailing address
8170 33Rd Ave S
Minneapolis, MN 55425-4516
Other practice location 1
357 Third Ave
Clear Lake Clinic, WI 54005-0177
Phone (715) 268-8000
Other practice location 2
550 Martin Ave W
Turtle Lake, WI 54889-9069
Phone (715) 986-4101
Other practice location 3
2547 State Road 35
Luck, WI 54853-4501
Phone (715) 472-2177
Other practice location 4
265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000
Other practice location 5
2220 Riverside Ave
Minneapolis, MN 55454-1321
Phone (612) 339-3663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007302200 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Medical College of Wisconsin, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
205 Wabasha Ave S
Saint Paul, MN 55107-1805
2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020
8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31706 | MN | MD | Family Medicine Physician |
| 66991-20 | WI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairview Express Care | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Healtheast St. John'S Hospital | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Fairview Express Care | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Fairview Clinics | Current | Accepting new patients | |
| University of Minnesota Physicians | Past | Accepting new patients |
Locations
1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617
8170 33rd Ave S
Stop 21110Q
Minneapolis, MN 55425
2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600
8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463
420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378
580 Rice St
Saint Paul, MN 55103
Phone (651) 227-6551
15290 Pennock Ln
Saint Paul, MN 55124
Phone (952) 431-8500
2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200
45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000
1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000
205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100
265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301
2547 State Road 35
Luck, WI 54853
Phone (715) 472-2177
550 Martin Ave W
Turtle Lake, WI 54889
Phone (715) 986-4101
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
-
- Primary Care Clinic/Center
- Minneapolis, MN
- NPI 1346432218
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1053952606
-
- General Acute Care Hospital
- Maplewood, MN
- NPI 1447218482
-
- Critical Access Hospital
- Amery, WI
- NPI 1093763518
-
- Clinic/Center
- Minneapolis, MN
- NPI 1114551546
-
- Primary Care Clinic/Center
- Saint Paul, MN
- NPI 1396552147
-
- General Practice Physician
- Edina, MN
- NPI 1831707207
-
- General Practice Dentistry
- Saint Paul, MN
- NPI 1952042053
-
- Rural Health Clinic/Center
- Clear Lake, WI
- NPI 1366878449
-
- Rural Health Clinic/Center
- Luck, WI
- NPI 1851345268
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1477598118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627516800000",
"number": "1417924481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15290 PENNOCK LN",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551247163",
"telephone_number": "952-853-8800",
"fax_number": "952-431-6966"
}
],
"practiceLocations": [
{
"address_1": "357 Third Ave",
"address_purpose": "LOCATION",
"city": "Clear Lake Clinic",
"state": "WI",
"postal_code": "540050177",
"country_code": "US",
"telephone_number": "715-268-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "550 Martin Ave W",
"address_purpose": "LOCATION",
"city": "Turtle Lake",
"state": "WI",
"postal_code": "548899069",
"country_code": "US",
"telephone_number": "715-986-4101",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2547 State Road 35",
"address_purpose": "LOCATION",
"city": "Luck",
"state": "WI",
"postal_code": "548534501",
"country_code": "US",
"telephone_number": "715-472-2177",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "265 Griffin St E",
"address_purpose": "LOCATION",
"city": "Amery",
"state": "WI",
"postal_code": "540011439",
"country_code": "US",
"telephone_number": "715-268-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2220 Riverside Ave",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554541321",
"country_code": "US",
"telephone_number": "612-339-3663",
"fax_number": "612-371-1732",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRANCEL",
"first_name": "MARK",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2021-07-29",
"certification_date": "2021-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "66991-20",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "31706",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007302200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Apple Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.