NPIMap

Individual provider Active NPI

Judy Lynn Fruehbrodt-Glenzinski, M.D.

  • Family Medicine Physician
  • Faribault, MN
National Provider Identifier
1649204645
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41619 Issued in MN
Practice address
300 State Ave
Faribault, MN 55021
Phone
(507) 333-3300
Fax
(507) 333-3214
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41619 MN Primary

Addresses

Primary practice location

300 State Ave
Faribault, MN 55021

Mailing address

300 State Ave
Faribault, MN 55021-6319
Phone (507) 333-3300

Other practice location 1

924 1st St NE
Faribault, MN 55021-5441
Phone (507) 333-3300

Other identifiers 2

IdentifierTypeStateIssuer
603219200MedicaidMN
080136009OtherRAIL ROAD MEDICARE

Other names 1

  • Judy Lynn Fruehbrodt Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jfruehbrodtglenzinski87370@ehrdirect.mayoclinicmsg.org

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
I20100527000774 MN Practitioner - Family Practice 2567591647 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

200 1St SWST
Rochester, MN 55905-0001

2200 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-1120

2250 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-3850

404 W Fountain St
Albert Lea, MN 56007-2437
Phone (507) 373-2384

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41619MNMDFamily Medicine Physician
8168MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 18, 2017 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2021 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 18, 2017 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Jul 1, 2021 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2021 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
St. John's Lutheran Home Past Accepting new patients
The Evangelical Lutheran Good Samaritan Society Past Accepting new patients
New Richland Care Center Past Accepting new patients
The Emeralds at Faribault LLC Past Accepting new patients
Benedictine Living Community Owatonna Past Accepting new patients
Benedictine Care Centers Past Accepting new patients

Locations

901 Luther Pl
Albert Lea, MN 56007
Phone (507) 373-8226

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

924 1st St NE
Faribault, MN 55021
Phone (507) 333-3300

300 State Ave
Faribault, MN 55021
Phone (507) 333-3300

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

2200 NW 26th St
Owatonna, MN 55060
Phone (507) 451-1120

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: jfruehbrodtglenzinski87370@ehrdirect.mayoclinicmsg.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Zumbrota Care CenterZumbrota, MN, CCN 245376 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025
Benedictine Living Community OwatonnaOwatonna, MN, CCN 245426 Skilled nursing facility Contracted Managing Employee Jan 1, 2024
St Johns Lutheran CommunityAlbert Lea, MN, CCN 245635 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Feb 12, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 33

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

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1649204645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 STATE AVE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216319",
            "telephone_number": "507-333-3300",
            "fax_number": "507-333-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 STATE AVE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "55021",
            "telephone_number": "507-333-3300",
            "fax_number": "507-333-3214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "924 1st St NE",
            "address_purpose": "LOCATION",
            "city": "Faribault",
            "state": "MN",
            "postal_code": "550215441",
            "country_code": "US",
            "telephone_number": "507-333-3300",
            "fax_number": "507-333-3214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRUEHBRODT-GLENZINSKI",
        "first_name": "JUDY",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "41619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "603219200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "080136009",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jfruehbrodtglenzinski87370@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "924 1st St NE",
            "city": "Faribault",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550215441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JUDY",
            "last_name": "FRUEHBRODT",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Faribault, MN

Sources for this page

Verify at the official NPI Registry.