Individual provider Active NPI

Mary C Bretzman, MD

  • Family Medicine Physician
  • Eagan, MN
National Provider Identifier
1760449771
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38118 Issued in MN
Practice address
1110 Yankee Doodle Rd
Eagan, MN 55121-2092
Phone
(651) 454-3970
Fax
(651) 905-5087
NPI assigned
Apr 26, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 38118 MN Primary

Addresses

Primary practice location

1110 Yankee Doodle Rd
Eagan, MN 55121-2092

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-4813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100802000405 MN Practitioner - Family Practice 2365575040 Reassigns benefits to 1 organization
I20210715001484 OH Practitioner - Family Practice 2365575040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emily Program P CGroup PAC ID 5193623254, 49 clinicians

Practice addresses (Care Compare)

2265 Como Ave
Saint Paul, MN 55108-1737
Phone (651) 645-5323

8001 Ravines Edge CT
Suite 201
Columbus, OH 43235-5423
Phone (888) 364-5977

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38118MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emily Program P C CurrentSince Jun 1, 2010 Accepting new patients
Emily Program PC Past Accepting new patients

Locations

1295 Bandana Blvd N
Ste 210
Saint Paul, MN 55108
Phone (888) 272-0784

2230 Como Ave
Saint Paul, MN 55108
Phone (651) 635-0095

2265 Como Ave
Saint Paul, MN 55108

3401 Enterprise Pkwy
Ste 250
Beachwood, OH 44122
Phone (216) 765-0500

8001 Ravines Edge Ct
Ste 201
Columbus, OH 43235
Phone (614) 896-8222

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1760449771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "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": "1110 YANKEE DOODLE RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212092",
            "telephone_number": "651-454-3970",
            "fax_number": "651-905-5087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETZMAN",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "38118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

Verify at the official NPI Registry.