Individual provider Active NPI

Mark L Brancel, MD

  • Family Medicine Physician
  • Apple Valley, MN
National Provider Identifier
1417924481
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31706 Issued in MN
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

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
007302200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100310000996 MN Practitioner - Family Practice 9032254362 Reassigns benefits to 4 organizations
I20170412001507 WI Practitioner - Family Practice 9032254362 Reassigns benefits to 2 organizations

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
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

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

LicenseStateTypeSpecialty
31706MNMDFamily Medicine Physician
66991-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 1998 Accepting new patients
Healtheast St. John'S Hospital CurrentSince Sep 1, 2020 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Apr 1, 2017 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Apr 1, 2017 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Nov 25, 2020 Accepting new patients
Group Health, Inc. Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince Dec 25, 2025 Accepting new patients
Fairview Clinics CurrentSince Nov 25, 2020 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.

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

Verify at the official NPI Registry.