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KARLY BRODERSEN
NPI 1568108256
Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Active since May 06, 2022PECOS Enrolled
420 DELAWARE ST SE, MMC 295, MINNEAPOLIS, MN 55455(612) 625-6519 Get Directions Write a Review

NPPES record last updated: May 6, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Karly Brodersen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KARLY BRODERSEN (NPI 1568108256) 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.

NPPES Registry Identity

NPI1568108256
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKARLY BRODERSEN
Location Address420 DELAWARE ST SE, MMC 295Minneapolis, MN 55455
Mailing Address420 Delaware St Se, Mmc 295Minneapolis, MN 55455 · (612) 625-6519
Phone(612) 625-6519
Sole ProprietorYes
Enumeration DateMay 6, 2022
NPPES CertifiedApril 20, 2022
✔ NPI 1568108256 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
420 DELAWARE ST SE, Minneapolis, MN 55455
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Karly Brodersen is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KHALID AMIN MD
Pathology (Anatomic Pathology & Clinical Pathology)
420 DELAWARE ST SE, C463 MAYO MEMORIAL BLDG, MAYO MAIL CODE 76
MINNEAPOLIS, MN 55455
Hennepin County (913) 827-3505
MELISSA RICHARDSON PA-C
Physician Assistant
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 273-3000
DR. RAID SAID MOUSA YOUSEF M.D.
Student in an Organized Health Care Education/Training Program
420 DELAWARE ST SE, MMC 11
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-7911
DR. DAVID YOUNG BALSER MD
Physical Medicine & Rehabilitation
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-2661
ALEXANDER TROESTER
Student in an Organized Health Care Education/Training Program
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-6483
NIKITHA VOBUGARI MD
Internal Medicine (Hematology & Oncology)
420 DELAWARE ST SE, MMC 480
MINNEAPOLIS, MN 55455
Hennepin County (612) 626-0400
THOMAS HOUGHLAND MD
Student in an Organized Health Care Education/Training Program
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 626-5589
DR. ANUSHA L GOPALAM MD
Student in an Organized Health Care Education/Training Program
420 DELAWARE ST SE
MINNEAPOLIS, MN 55455
Hennepin County (612) 625-5454

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 Karly Brodersen's NPI number?

The NPI number for Karly Brodersen is 1568108256. It was assigned to this individual provider in the NPPES registry on May 6, 2022.

Where is Karly Brodersen located?

Karly Brodersen practices at 420 Delaware St SE Mmc 295, Minneapolis, MN 55455. The listed phone number is (612) 625-6519.

What is Karly Brodersen's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Karly Brodersen enrolled in Medicare?

Yes. Karly Brodersen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Karly Brodersen was last updated on May 6, 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.