Brennan Joseph Shutt, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

65224 Issued in MN

Practice address

3300 Oakdale Ave N
Robbinsdale, MN 55422

Phone

(763) 520-5200

Fax

(763) 581-4771

NPI assigned

Mar 13, 2012

Last updated

May 13, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Specialty

Internal Medicine

Education

Other, 2012

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)

Hospital & facility affiliations

• Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214
• North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment Care Compare group NPD
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552
  NPD

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

• Maple Grove Hospital Corporation

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1225272552
  Care Compare affiliation
• North Memorial Health Care

  dba North Memorial Ambulance Service

  • Ambulance
  • Brooklyn Center, MN
  • NPI 1538195912

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  dba North Memorial Health Specialty Center - Robbinsdale

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1699953000

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Care Compare affiliation

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1689949448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-520-5200",
            "fax_number": "763-581-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "763-520-5200",
            "fax_number": "763-581-4771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Oakdale Ave N",
            "address_purpose": "LOCATION",
            "city": "Robbinsdale",
            "state": "MN",
            "postal_code": "55422",
            "country_code": "US",
            "telephone_number": "763-520-5200",
            "fax_number": "763-581-4771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUTT",
        "first_name": "BRENNAN",
        "middle_name": "JOSEPH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-13",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02004294A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A14186",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "65224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Steven Shea, CRNA
• Kristen Shenk, CRNA
• Mubashir Sheriff, DMD
• Kelsey Sherwood, PA-C
• Mary Shields, NP
• Allyson C Sima, PT
• Marno Kay Simon, OTR
• Neil McDevitt Skemp, M.D.
• Lisa Dawn Skinner, MD
• Anne Slanina, PSYD, LP

• Internal Medicine Physician in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.