NPIMap

Individual provider Active NPI

Brandon Walker

  • Medical Physician Assistant
  • St. Paul, MN
National Provider Identifier
1811201957
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
11262 Issued in MN
Practice address
2004 Ford Parkway
Ms 35300a
St. Paul, MN 55116-1931
Phone
(651) 265-0000
Fax
(651) 265-0001
NPI assigned
Jul 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Medical Physician Assistant 363AM0700X 11262 MN Primary

Addresses

Primary practice location

2004 Ford Parkway
Ms 35300a
St. Paul, MN 55116-1931

Mailing address

8170 33Rd Ave S - PO Box 1309
Ms 21110Q
Minneapolis, MN 55425-4516
Phone (651) 265-0000

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
I20130225000455 MN Practitioner - Physician Assistant 5597910455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

205 Wabasha Ave S
Saint Paul, MN 55107-1805

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-0020

4730 Chicago Ave S
Minneapolis, MN 55407-3570
Phone (952) 967-7485

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
11262MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Dec 21, 2012 Accepting new patients
Group Health, Inc. CurrentSince Apr 1, 2015 Accepting new patients
Fairview Health Services CurrentSince Dec 21, 2012 Accepting new patients
Group Health, Inc. CurrentSince Apr 1, 2015 Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

4730 Chicago Ave
Minneapolis, MN 55407
Phone (612) 313-0000

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

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

2004 Ford Pkwy
#35300A
Saint Paul, MN 55116
Phone (651) 265-0000

Organizations & group practices 5

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 8

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": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1811201957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S - PO BOX 1309",
            "address_2": "MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-265-0000",
            "fax_number": "651-265-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 FORD PARKWAY",
            "address_2": "MS 35300A",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551161931",
            "telephone_number": "651-265-0000",
            "fax_number": "651-265-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-30",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "11262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Paul, MN

Sources for this page

Verify at the official NPI Registry.