Active NPI
Roderick Benjamin Brown, M.D.
- Family Medicine Physician
- Glenwood, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 26202
- Practice address
- 10 4TH Ave SE
Glenwood, MN 56334-1820 - Phone
- (320) 634-2215
- Fax
- (320) 634-2262
- NPI assigned
- Jul 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26202 | MN | Primary |
Addresses
Primary practice location
10 4TH Ave SE
Glenwood, MN 56334-1820
Mailing address
10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-2215
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01-08141 | Other | MEDICA | |
| 01-20641 | Other | MEDICA | |
| 01-06787 | Other | MEDICA | |
| FP0356 | Other | ARAZ | |
| 110886 | Other | UCARE | |
| 21082BR | Other | MN | BLUE CROSS |
| 39-40025 | Other | MEDICA | |
| 4T897BR | Other | MN | BLUE CROSS |
| 1004387 | Other | PREFERRED ONE | |
| HP25406 | Other | HEALTH PARTNERS |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Minnesota Medical School, 1980
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521
417 Franklin St S
Glenwood, MN 56334-1518
Phone (320) 634-5157
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26202 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glacial Ridge Hospital District | Current | Accepting new patients | |
| Glacial Ridge Hospital District | Family Medicine | Current | Accepting new patients |
| Glacial Ridge Hospital District | Current | Accepting new patients | |
| Glacial Ridge Hospital District | Current | Accepting new patients | |
| Glacial Ridge Hospital District | Past | Accepting new patients |
Locations
10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157
417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/glac-1755385c
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Brooten Medical Center
- Family Medicine Physician
- Brooten, MN
- NPI 1255348223
-
dba Starbuck Medical Center
- Rural Health Clinic/Center
- Starbuck, MN
- NPI 1063952026
-
dba Glenwood Family Eye Center
- Optometrist
- Glenwood, MN
- NPI 1306206446
-
- Critical Access Hospital
- Glenwood, MN
- NPI 1538178520
-
dba Glacial Ridge Homecare
- Home Health Agency
- Glenwood, MN
- NPI 1922017052
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Glenwood, MN
- NPI 1538178520
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942214002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 4TH AVE SE",
"city": "GLENWOOD",
"state": "MN",
"postal_code": "563341820",
"telephone_number": "320-634-2215",
"fax_number": "320-634-2262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 4TH AVE SE",
"city": "GLENWOOD",
"state": "MN",
"postal_code": "563341820",
"telephone_number": "320-634-2215",
"fax_number": "320-634-2262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "RODERICK",
"middle_name": "BENJAMIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "26202",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "01-08141",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "01-20641",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "01-06787",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARAZ",
"identifier": "FP0356",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "110886",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "21082BR",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "39-40025",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "4T897BR",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1004387",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP25406",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glenwood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.