NPIMap

Individual provider Active NPI

Michael Brogan

  • Neurology Physician
  • St. Paul, MN
National Provider Identifier
1982848412
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
59088 Issued in MN
Practice address
640 Jackson Street
MC 41104C
St. Paul, MN 55101
Phone
(651) 254-7900
Fax
(651) 254-7904
NPI assigned
Apr 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 59088 MN Primary

Addresses

Primary practice location

640 Jackson Street
MC 41104C
St. Paul, MN 55101

Mailing address

PO Box 1309
8170 33Rd Ave S - Ms 21110Q
Minneapolis, MN 55425-4516
Phone (651) 254-7900

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
I20150601002388 MN Practitioner - Critical Care (Intensivists)Practitioner - Neurology 7810218914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Neurology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 221-3456

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (612) 932-5000

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

Hospital & facility affiliations

  • Regions Hospital Hospital, Saint Paul, MN, CCN 240106
  • Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066
  • Hudson Hospital Hospital, Hudson, WI, CCN 521335

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59088MNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jul 6, 2015 Accepting new patients
The Metrohealth System Current Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Group Health, Inc. CurrentSince Jul 6, 2015 Accepting new patients
Park Nicollet Clinic CurrentSince Apr 5, 2017 Accepting new patients
Park Nicollet Clinic CurrentSince Apr 5, 2017 Accepting new patients
Regions Hospital Past Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

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

640 Jackson St
#41104C
Saint Paul, MN 55101
Phone (651) 254-7900

3931 Louisiana Ave S
St Louis Park, MN 55426
Phone (952) 993-3230

Interoperability endpoints

  • Direct secure messaging: mbrogan95327@direct.metrohealth.org

Organizations & group practices 7

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 11

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

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1982848412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "address_2": "8170 33RD AVE S - MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-7900",
            "fax_number": "651-254-7904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON STREET",
            "address_2": "MC 41104C",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55101",
            "telephone_number": "651-254-7900",
            "fax_number": "651-254-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-28",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MN",
            "license": "59088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Paul, MN

Sources for this page

Verify at the official NPI Registry.