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DR. BRIAN A CAPPS MD
NPI 1629028857
Family Medicine in Duluth, MN

Active since May 10, 2006PECOS EnrolledAccepts Medicare Assignment
26 E SUPERIOR ST STE 205, DULUTH, MN 55802(218) 249-4300(218) 249-4350 Get Directions Write a Review

NPPES record last updated: December 4, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 4, 2020, Feb 2, 2017 (2 updates tracked since 2017).

About Dr. Brian A Capps Md NPPES

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

DR. BRIAN A CAPPS MD (NPI 1629028857) is an individual family medicine provider in Duluth, Minnesota, licensed in Minnesota (43614) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with St Lukes Hospital, and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (2000).

NPPES Registry Identity

NPI1629028857
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. BRIAN A CAPPSCredential: MD
Location Address26 E SUPERIOR ST STE 205Duluth, MN 55802-2196
Mailing Address26 E Superior St Ste 205Duluth, MN 55802-2196 · (218) 249-4300 · Fax (218) 249-4350
Phone(218) 249-4300
Fax(218) 249-4350
Sole ProprietorNo
Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2000
Enumeration DateMay 10, 2006
Last NPPES UpdateDecember 4, 20202 updates tracked since enumeration
NPPES CertifiedDecember 4, 2020
✔ NPI 1629028857 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MN · 43614
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
26 E SUPERIOR ST STE 205, Duluth, MN 55802
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Other Identifiers 1

Medicaid34408100WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Security Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Brian A Capps Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749180628
PECOS Enrollment IDI20040109000129, I20091211000373
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Brian Capps reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Luke's Hospital Of Duluth
0.1 mi
Family Medicine
26 E SUPERIOR ST, STE 205
Duluth, MN 55802
  • Reassigned Medicare billing, Minnesota enrollment
  • 513 clinicians in this Medicare group
NPI 1306870654 (218) 249-4300
Memorial Medical Center Inc
60 mi
Critical Access
1615 MAPLE LN
Ashland, WI 54806
  • Reassigned Medicare billing, Wisconsin enrollment
  • 175 clinicians in this Medicare group
NPI 1437179231 (715) 685-5500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
82 services47 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
40 services40 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
25 services24 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
20 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Lukes Hospital

Acute Care Hospitals · Duluth, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240047
Location915 East 1st StreetDuluth, MN 55805 · St. Louis County
Emergency services Birthing friendly

Tamarack Health Ashland Medical Center

Critical Access Hospitals · Ashland, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number521359
Location1615 Maple LaneAshland, WI 54806 · Ashland County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55802 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers18 claims40 services$5.06 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

DR. JOEL NATHANIEL EDWALL MD
Family Medicine
26 E SUPERIOR ST STE 205
DULUTH, MN 55802
St. Louis County (218) 249-5555
CHELSEA CROUCH
Family Medicine
26 E SUPERIOR ST STE 205
DULUTH, MN 55802
St. Louis County (218) 249-5555

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 Brian Capps's NPI number?

The NPI number for Brian Capps is 1629028857. It was assigned to this individual provider in the NPPES registry on May 10, 2006.

Where is Brian Capps located?

Brian Capps practices at 26 E Superior St Ste 205, Duluth, MN 55802. The listed phone number is (218) 249-4300.

What is Brian Capps's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Brian Capps enrolled in Medicare?

Yes. Brian Capps is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Brian Capps's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Brian Capps reassigns Medicare benefits to 2 organizations: St. Luke's Hospital Of Duluth (Duluth, MN) and Memorial Medical Center Inc (Ashland, WI). 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 Brian Capps's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Brian Capps accept?

Health plans from Anthem Blue Cross and Blue Shield and Security Health Plan list Brian Capps as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Brian Capps affiliated with any hospitals?

According to CMS data, Brian Capps is affiliated with St Lukes Hospital and Tamarack Health Ashland Medical Center.

When was this NPI record last updated?

The NPPES record for Brian Capps was last updated on December 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.