TAYLOR BROCKMAN MD
NPI 1003551284
Student in an Organized Health Care Education/Training Program in Minneapolis, MN
About Taylor Brockman Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TAYLOR BROCKMAN MD (NPI 1003551284) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS, is affiliated with M Health Fairview University Of Mn, and is a graduate of Medical College Of Wisconsin (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Taylor Brockman Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Taylor Brockman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Minneapolis, MN 55454
- Reassigned Medicare billing, Minnesota enrollment
- 2,302 clinicians in this Medicare group
Saint Paul, MN 55104
- Reassigned Medicare billing, Minnesota enrollment
- 2,361 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
M Health Fairview University Of Mn
Acute Care Hospitals · Minneapolis, MNOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MINNEAPOLIS, MN 55455
MINNEAPOLIS, MN 55455
MINNEAPOLIS, MN 55455
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Taylor Brockman's NPI number?
The NPI number for Taylor Brockman is 1003551284. It was assigned to this individual provider in the NPPES registry on May 2, 2022.
Where is Taylor Brockman located?
Taylor Brockman practices at 420 Delaware Street SE, Mmc 913, Minneapolis, MN 55455. The listed phone number is (612) 624-0990.
What is Taylor Brockman's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Taylor Brockman enrolled in Medicare?
Yes. Taylor Brockman is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Taylor Brockman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Taylor Brockman reassigns Medicare benefits to 2 organizations: Fairview Clinics (Minneapolis, MN) and Healtheast Medical Research Institute (Saint Paul, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Taylor Brockman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Taylor Brockman affiliated with any hospitals?
According to CMS data, Taylor Brockman is affiliated with M Health Fairview University Of Mn.
When was this NPI record last updated?
The NPPES record for Taylor Brockman was last updated on May 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Taylor Brockman, MD · NPI 1003551284
Student in an Organized Health Care Education/Training Program provider in Minneapolis, Minnesota. Individual provider, active in the CMS NPPES registry since May 2, 2022.
## Identity
- **NPI:** 1003551284 (Entity type: Individual)
- **Enumerated:** May 2, 2022
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 420 DELAWARE STREET SE, MMC 913, Minneapolis, MN 55455-0341
- **Phone:** (612) 624-0990
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Fairview Clinics (NPI 1043516867, Minneapolis, MN); Healtheast Medical Research Institute (NPI 1508191552, Saint Paul, MN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Medical College Of Wisconsin, class of 2022
## Record status
- **NPPES last updated:** May 18, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1003551284) · Data from the CMS NPPES public registry.