Kevin Anthony Brueske

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

65419 Issued in MN

Practice address

5200 Fairview Blvd
Wyoming, MN 55092

Phone

(651) 982-7000

NPI assigned

Apr 11, 2016

Last updated

Jul 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbrueske487981@fairview.direct-ci.com

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.

• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  dba Fairview Clinics-Blaine

  • Multi-Specialty Clinic/Center
  • Blaine, MN
  • NPI 1972784205
  NPD
• Fairview Express Care

  dba University of Minnesota Physicians Heart at Fairview

  • Cardiovascular Disease Physician
  • Edina, MN
  • NPI 1710133343
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Fairview Health Services

  dba Fairview Northland Hospital

  • General Acute Care Hospital
  • Princeton, MN
  • NPI 1922085299
  NPD
• Fairview Clinics

  dba Fairview Clinics-Maple Grove

  • Multi-Specialty Clinic/Center
  • Maple Grove, MN
  • NPI 1841315165
  NPD (past)
• Fairview Express Care

  dba M Health Fairview Orthopedic Clinic -Ridges

  • Multi-Specialty Clinic/Center
  • Burnsville, MN
  • NPI 1083806772
  NPD (past)
• Fairview Express Care

  • Eyewear Supplier
  • Fridley, MN
  • NPI 1942482740
  NPD (past)

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1588028955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 STINSON BLVD FL 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "55092",
            "telephone_number": "651-982-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUESKE",
        "first_name": "KEVIN",
        "middle_name": "ANTHONY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "65419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Ann Bera, M.D.
• Borealis Dental Wyoming PA
• Gretchen Bosacker, M.D.
• Faith Bouttell
• Nissa K Brekke
• Jessica Lee Tomlin Brunfelt, NP
• Judy A Buda, CRNA
• Elizabeth Cabrera, D.O.
• James M Cain, MD
• Michael Robert Campoli, M.D., PH.D.

• Pediatrics Physician in Wyoming, MN
• Providers in Wyoming, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.