NPIMap

Individual provider Active NPI

Brenna Aden Rutherford, PAC

  • Medical Physician Assistant
  • Saint Paul, MN
National Provider Identifier
1497040026
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10947 Issued in MN
Practice address
333 Smith Ave N
Saint Paul, MN 55102-2344
Phone
(651) 241-8000
NPI assigned
Jun 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10947 MN Primary

Addresses

Primary practice location

333 Smith Ave N
Saint Paul, MN 55102-2344

Mailing address

2829 University Ave SE Ste 730
Minneapolis, MN 55414-3279

Other identifiers 1

IdentifierTypeStateIssuer
1098260OtherMNPA LICENSURE - NCCPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111219000340 MN Practitioner - Physician Assistant 5496920514 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

1000 W 140TH St
Unit 201
Burnsville, MN 55337-4833
Phone (952) 808-3000

2855 Campus Dr
Plymouth, MN 55441-2649
Phone (763) 577-7160

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

4010 W 65TH St
Edina, MN 55435-1706
Phone (952) 456-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
95.08
Improvement activities
40
Cost
81.67

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
95.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Jun 1, 2014 Accepting new patients
Infinite Health Collaborative, PA CurrentSince Jun 1, 2014 Accepting new patients
Ecc Addiction & Toxicology Services LLC CurrentSince Jun 21, 2022 Accepting new patients
Allina Health System CurrentSince Nov 2, 2011 Accepting new patients
Allina Health System CurrentSince Nov 2, 2011 Accepting new patients
Allina Health System Past Accepting new patients
Regina Medical Center Past Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
St. Croix Orthopaedics, PA Past Accepting new patients
Allina Health System Past Accepting new patients

Locations

11225 Ulysses St NE
Blaine, MN 55434
Phone (763) 302-2600

1000 W 140th St
Unit 201
Burnsville, MN 55337
Phone (952) 808-3000

2700 Vikings Cir
Eagan, MN 55121
Phone (952) 456-7600

1175 Nininger Rd
Hastings, MN 55033
Phone (651) 404-1000

9630 Grove Cir N
Ste 200
Maple Grove, MN 55369
Phone (763) 520-7580

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

4010 W 65th St
Minneapolis, MN 55435
Phone (952) 456-7000

2829 University Ave SE
Ste 730
Minneapolis, MN 55414
Phone (612) 439-1868

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

800 E 28th St
#11112
Minneapolis, MN 55407
Phone (612) 863-4233

16800 37th Pl N
#200
Plymouth, MN 55446
Phone (635) 207-8707

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

820 Village Way
#200
Waconia, MN 55387

4040 Radio Dr
Woodbury, MN 55129
Phone (514) 398-8076

1400 N Acres Rd
Ste 30
Prescott, WI 54021
Phone (651) 437-3121

1629 E Division St
River Falls, WI 54022
Phone (715) 307-6000

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 41

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

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1307750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1497040026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 UNIVERSITY AVE SE STE 730",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SMITH AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022344",
            "telephone_number": "651-241-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "BRENNA",
        "middle_name": "ADEN",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-11",
        "last_updated": "2023-11-02",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "10947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSURE - NCCPA",
            "identifier": "1098260",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.