Individual provider Active NPI

Michael Brendan O'Sullivan, MD

  • Psychiatry Physician
  • Minneapolis, MN
National Provider Identifier
1962547901
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
19405 Issued in MN
Practice address
2450 Riverside Ave # F273
Minneapolis, MN 55454-1450
Phone
(612) 273-8700
Fax
(612) 273-8727
NPI assigned
Feb 20, 2007
Last updated
Aug 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 19405 MN Primary

Addresses

Primary practice location

2450 Riverside Ave # F273
Minneapolis, MN 55454-1450

Mailing address

2450 Riverside Ave # F273
Minneapolis, MN 55454-1450

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
I20100728001141 MN Practitioner - Psychiatry 2163555046 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians
Innovative Psychological Consultants, LLCGroup PAC ID 3678596285, 15 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-7838

7236 Forestview Lane N
Maple Grove, MN 55369

7236 Forestview LN N
Maple Grove, MN 55369-5656
Phone (763) 416-4167

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19405MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Nov 16, 2015 Accepting new patients
Fairview Express Care CurrentSince Nov 12, 2021 Accepting new patients
Fairview Health Services CurrentSince Jan 5, 2022 Accepting new patients
Fairview Express Care CurrentSince Nov 12, 2021 Accepting new patients
Innovative Psychological Consultants, LLC CurrentSince Oct 30, 2010 Accepting new patients
Allina Health System CurrentSince Nov 16, 2015 Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

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

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

7236 Forestview Ln N
Maple Grove, MN 55369
Phone (763) 416-4167

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2450 Riverside Ave
#F273
Minneapolis, MN 55454
Phone (612) 273-8700

2450 Riverside Ave
Ste F140
Minneapolis, MN 55454
Phone (651) 464-4847

2512 S 7th St
Minneapolis, MN 55454
Phone (612) 273-4277

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

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

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

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

800 E 28th St
#600
Minneapolis, MN 55407
Phone (612) 863-5327

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

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1962547901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE # F273",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE # F273",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-273-8700",
            "fax_number": "612-273-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "MICHAEL",
        "middle_name": "BRENDAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "19405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.