Individual provider Active NPI

Brandon Michael Nathan, M.D.

  • Pediatric Endocrinology Physician
  • Minneapolis, MN
National Provider Identifier
1891738530
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
48500 Issued in CA
Practice address
420 Delaware Sr. SE
University of Minnesota Physicians , MMC 404
Minneapolis, MN 55455
Phone
(612) 626-6777
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 48500 MN
Pediatric Endocrinology Physician 2080P0205X 48500 CA Primary

Addresses

Primary practice location

420 Delaware Sr. SE
University of Minnesota Physicians , MMC 404
Minneapolis, MN 55455

Mailing address

420 Delaware Sr. SE
University of Minnesota Physicians, MMC 404
Minneapolis, MN 55455
Phone (612) 626-6777

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060925000144 MN Practitioner - Pediatric Medicine 0749285856 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Geisel School of Medicine at Dartmouth, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

17705 Hutchins Dr
Suite 100
Minnetonka, MN 55345-4145
Phone (952) 401-8300

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48500MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics CurrentSince Mar 13, 2020 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 1, 2006 Accepting new patients
Fairview Express Care Current Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services CurrentSince Mar 13, 2020 Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients

Locations

303 E Nicollet Blvd
Ste 372
Burnsville, MN 55337
Phone (612) 626-6777

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

420 Delaware St SE
#404
Minneapolis, MN 55455
Phone (612) 624-5409

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

17705 Hutchins Dr
Ste 100
Minnetonka, MN 55345
Phone (763) 420-1010

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

9680 Tamarack Rd
Ste 130
Woodbury, MN 55125
Phone (612) 273-1172

Interoperability endpoints

  • Direct secure messaging: bnathan40227@fairview.direct-ci.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1891738530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE SR. SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS, MMC 404",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE SR. SE",
            "address_2": "UNIVERSITY OF MINNESOTA PHYSICIANS , MMC 404",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "48500",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CA",
            "license": "48500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.