NPIMap

Individual provider Active NPI

Brooke Habisch

  • Acute Care Nurse Practitioner
  • Saint Louis Park, MN
National Provider Identifier
1871914887
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
6118 Issued in MN
Practice address
5320 W 23Rd St
Saint Louis Park, MN 55416
Phone
(952) 345-8770
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Exercise Physiologist 224Y00000X
Acute Care Nurse Practitioner 363LA2100X 6118 MN Primary

Addresses

Primary practice location

5320 W 23Rd St
Saint Louis Park, MN 55416

Mailing address

5320 W 23Rd St
Saint Louis Park, MN 55416

Other practice location 1

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-6426

Other practice location 2

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 656-7020

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
I20181019001406 MN Practitioner - Nurse Practitioner 6204189368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Consultative Health and Medicine PAGroup PAC ID 6305024373, 14 clinicians

Practice addresses (Care Compare)

5520 Ridgewood CV
Minnetrista, MN 55364-8239
Phone 80087305611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.25 of 100Reported as group
Quality
60.43
Promoting interoperability
83
Improvement activities
40
Cost
79.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6118MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespark Medical Group, PA CurrentSince Apr 24, 2023 Accepting new patients
Consultative Health and Medicine, PA CurrentSince Dec 1, 2025 Accepting new patients

Locations

5320 W 23rd St
Ste 130
St Louis Park, MN 55416
Phone (952) 345-3213

5320 W 23rd St
St Louis Park, MN 55416
Phone (952) 345-8770

Interoperability endpoints

  • Direct secure messaging: brooke.habisch.1@15699.direct.athenahealth.com

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1871914887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 W 23RD ST",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "55416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 W 23RD ST",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "952-345-8770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 Northland Dr",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "MN",
            "postal_code": "553712172",
            "country_code": "US",
            "telephone_number": "763-389-6426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1406 6th Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "56303",
            "country_code": "US",
            "telephone_number": "320-656-7020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HABISCH",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MN",
            "license": "6118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis Park, MN

Sources for this page

Verify at the official NPI Registry.