Individual provider Active NPI

Brenna Leigh Radermacher, DNP, APRN, AGNP-C

  • Adult Health Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1619499860
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5247 Issued in MN
Practice address
500 Harvard St SE Unit 7D
Minneapolis, MN 55455-0363
Phone
(612) 273-3074
NPI assigned
Jul 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2085531 MN
Adult Health Nurse Practitioner 363LA2200X 5247 MN Primary

Addresses

Primary practice location

500 Harvard St SE Unit 7D
Minneapolis, MN 55455-0363

Mailing address

1425 Hampshire Ave S Apt 323
St Louis Park, MN 55426-2163
Phone (507) 995-0654

Other names 1

  • Brenna Leigh Hawkins Former name

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
I20170807000837 MN Practitioner - Nurse Practitioner 6507137775 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Minnesota Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400

3435 W Broadway Ave
Robbinsdale, MN 55422-2969
Phone (763) 581-2800

8100 42ND Ave N
New Hope, MN 55427-1107
Phone (763) 581-2273

9825 Hospital Dr
Maple Grove, MN 55369-4479
Phone (763) 581-5400

9855 Hospital Dr
Maple Grove, MN 55369-4648

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 581-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2085531MNMDRegistered Nurse
5247MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
North Memorial Health Care CurrentSince May 1, 2019 Accepting new patients
Centracare Health System-NR LLC CurrentSince Jan 1, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Oct 28, 2017 Accepting new patients
North Memorial Health Care Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Centracare Health System-NR LLC CurrentSince Jan 1, 2020 Accepting new patients

Locations

9855 Hospital Dr
Ste 104
Maple Grove, MN 55369
Phone (763) 581-5900

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

500 Harvard St SE
Unit 7D
Minneapolis, MN 55455
Phone (612) 273-2844

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

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

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2450 Riverside Ave
Ste F140
Minneapolis, MN 55454
Phone (651) 464-4847

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

1013 Hart Blvd
Ste 1
Monticello, MN 55362
Phone (763) 271-2405

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

3435 W Broadway Ave
Robbinsdale, MN 55422
Phone (763) 520-7887

Interoperability endpoints

  • Direct secure messaging: bradermacher139478@direct.northmemorial.com
  • Direct secure messaging: bradermacher500128@direct.centracare.com

Organizations & group practices 10

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 5

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": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1619499860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 HAMPSHIRE AVE S APT 323",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554262163",
            "telephone_number": "507-995-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE UNIT 7D",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADERMACHER",
        "first_name": "BRENNA",
        "middle_name": "LEIGH",
        "credential": "DNP, APRN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2085531",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "5247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENNA",
            "last_name": "HAWKINS",
            "middle_name": "LEIGH",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.