NPIMap

Individual provider Active NPI

Peter A Bretzman, MD

  • Vascular & Interventional Radiology Physician
  • Edina, MN
National Provider Identifier
1902884117
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
38119 Issued in MN
Practice address
4100 Minnesota Dr. Suite 310
Edina, MN 55435-1421
Phone
(952) 929-5600
NPI assigned
Jan 6, 2006
Last updated
May 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 38119 MN
Vascular & Interventional Radiology Physician 2085R0204X 38119 MN Primary

Addresses

Primary practice location

4100 Minnesota Dr. Suite 310
Edina, MN 55435-1421

Mailing address

3500 American Blvd W Suite 300
Bloomington, MN 55431-4442

Other identifiers 1

IdentifierTypeStateIssuer
548017500MedicaidMN

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
I20050222000031 MN Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 4082528013 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of Minnesota Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infinite Health Collaborative, PAGroup PAC ID 1052225042, 815 clinicians

Practice addresses (Care Compare)

4100 Minnesota Dr
Edina, MN 55435-5417
Phone (952) 456-7000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal269
Leg revascularization (restoring blood flow)30
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Altru Health System CurrentSince Oct 17, 2011 Accepting new patients
Altru Health System CurrentSince May 1, 2011 Accepting new patients
Infinite Health Collaborative, PA Vascular & Interventional Radiology CurrentSince May 15, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Infinite Health Collaborative, PA CurrentSince May 15, 2022 Accepting new patients
Allina Health System CurrentSince Apr 14, 2014 Accepting new patients
Altru Health System CurrentSince May 1, 2011 Accepting new patients
Minneapolis Radiology Associates, LTD. Diagnostic Radiology CurrentSince Apr 30, 2017 Accepting new patients
Minnesota Diagnostic Imaging Partners, LLC Diagnostic Radiology CurrentSince Apr 30, 2017 Accepting new patients
Infinite Health Collaborative, PA Past Accepting new patients
Christian Unity Hospital Corporation Past Accepting new patients

Locations

400 S Minnesota St
Crookston, MN 56716
Phone (218) 281-9100

4100 Minnesota Dr
Edina, MN 55435
Phone (952) 456-7000

4100 Minnesota Dr
Ste 310
Edina, MN 55435
Phone (952) 838-0650

1010 S Birch Ave
Hallock, MN 56728
Phone (218) 843-3612

9855 Hospital Dr
Ste 150
Maple Grove, MN 55369
Phone (763) 398-6341

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

3500 American Blvd W
Ste 300
Minneapolis, MN 55431
Phone (952) 512-5600

4200 Dahlberg Dr
Ste 300
Minneapolis, MN 55422
Phone (952) 512-5600

920 E 28th St
Ste 440
Minneapolis, MN 55407
Phone (612) 863-5155

2800 Campus Dr
Ste 10
Plymouth, MN 55441
Phone (763) 398-4400

2800 Campus Dr
Ste 20
Plymouth, MN 55441
Phone (763) 398-8700

2800 Campus Dr
Ste 30
Plymouth, MN 55441
Phone (763) 398-2203

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

166 4th St E
Saint Paul, MN 55101
Phone (651) 292-2009

166 4th St E
Ste 100
Saint Paul, MN 55101

2355 Highway 36 W
Ste 100
Saint Paul, MN 55113
Phone (651) 292-0000

333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

2600 65th Ave
Osceola, WI 54020
Phone (705) 268-8000

Organizations & group practices 11

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1902884117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 AMERICAN BLVD W SUITE 300",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554314442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 MINNESOTA DR. SUITE 310",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351421",
            "telephone_number": "952-929-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRETZMAN",
        "first_name": "PETER",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "38119",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MN",
            "license": "38119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "548017500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.