SONJA BROCKMAN DNP, FNP-BC
NPI 1205465564
Nurse Practitioner - Family in Roseville, MN
About Sonja Brockman Dnp, Fnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SONJA BROCKMAN DNP, FNP-BC (NPI 1205465564) is an individual family provider in Roseville, Minnesota, licensed in Minnesota (6259) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2018).
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)
Sonja Brockman Dnp, Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Sonja Brockman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
White Bear Lake, MN 55110
- Reassigned Medicare billing, Minnesota enrollment
- 3 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55113 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Sonja Brockman's NPI number?
The NPI number for Sonja Brockman is 1205465564. It was assigned to this individual provider in the NPPES registry on April 7, 2020.
Where is Sonja Brockman located?
Sonja Brockman practices at 2685 Long Lake Rd Ste 105, Roseville, MN 55113. The listed phone number is (651) 633-6522.
What is Sonja Brockman's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Sonja Brockman enrolled in Medicare?
Yes. Sonja Brockman is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Sonja Brockman's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sonja Brockman reassigns Medicare benefits to North Star Medical PLLC (White Bear Lake, MN). The 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 Sonja Brockman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Sonja Brockman was last updated on May 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Sonja Brockman, DNP, FNP-BC · NPI 1205465564
Family physician in Roseville, Minnesota. Individual provider, active in the CMS NPPES registry since April 7, 2020.
## Identity
- **NPI:** 1205465564 (Entity type: Individual)
- **Enumerated:** April 7, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 6259 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 2685 LONG LAKE RD STE 105, Roseville, MN 55113-1117
- **Phone:** (651) 633-6522
## 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:** North Star Medical PLLC (NPI 1548068968, White Bear Lake, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** May 16, 2020
---
Source: [NPI Profile](https://npiprofile.com/npi/1205465564) · Data from the CMS NPPES public registry.