Active NPI
Peter Samuel Brodrick, MD
- Psychiatry Physician
- Saint Paul, MN
National Provider Identifier
1720041528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 45519
- Practice address
- 360 Sherman St
Suite 100
Saint Paul, MN 55102-2564 - Phone
- (651) 241-5080
- Fax
- (651) 241-5958
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 45519 | MN | Primary |
Addresses
Primary practice location
360 Sherman St
Suite 100
Saint Paul, MN 55102-2564
Mailing address
PO Box 43
Mr 10809
Minneapolis, MN 55440-0043
Phone (612) 262-4813
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34122300 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45519 | MN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Past | Accepting new patients | |
| Allina Health System | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1760446256
-
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1720041528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 43",
"address_2": "MR 10809",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554400043",
"telephone_number": "612-262-4813",
"fax_number": "612-262-4194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 SHERMAN ST",
"address_2": "SUITE 100",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551022564",
"telephone_number": "651-241-5080",
"fax_number": "651-241-5958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODRICK",
"first_name": "PETER",
"middle_name": "SAMUEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-11",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "45519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34122300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.