DR. DUSTIN BROCKBERG PHD
NPI 1801422928
Psychologist in Minneapolis, MN

Active since March 20, 2020PECOS EnrolledAccepts Medicare Assignment
800 E 28TH ST STE 1750, MINNEAPOLIS, MN 55407(612) 863-4495 Get Directions Write a Review

NPPES record last updated: April 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 3, 2020, Mar 20, 2020 (2 updates tracked since 2020).

About Dr. Dustin Brockberg Phd NPPES

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

DR. DUSTIN BROCKBERG PHD (NPI 1801422928) is an individual psychologist in Minneapolis, Minnesota, licensed in Minnesota (LP6577) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Center City, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1801422928
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. DUSTIN BROCKBERGCredential: PHD
Location Address800 E 28TH ST STE 1750Minneapolis, MN 55407-3723
Mailing Address2925 Chicago AveMinneapolis, MN 55407-1321 · (612) 262-9000
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMarch 20, 2020
Last NPPES UpdateApril 27, 20232 updates tracked since enumeration
NPPES CertifiedApril 27, 2023
NPI 1801422928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP6577
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
800 E 28TH ST STE 1750, Minneapolis, MN 55407

Secondary Practice Location 1

Location 115251 Pleasant Valley RdCenter City, MN 55012-9640 · Phone (651) 213-4078

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Dustin Brockberg Phd 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 ID9335510395
PECOS Enrollment IDI20230130002448
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.

Physical Medicine & Rehabilitation
800 E 28TH ST STE 1750
MINNEAPOLIS, MN 55407
Psychologist (Clinical)
800 E 28TH ST STE 1750
MINNEAPOLIS, MN 55407
Nurse Practitioner (Adult Health)
800 E 28TH ST STE 1750
MINNEAPOLIS, MN 55407
Social Worker (Clinical)
800 E 28TH ST STE 1750
MINNEAPOLIS, MN 55407
Nurse Practitioner (Adult Health)
800 E 28TH ST STE 1750
MINNEAPOLIS, MN 55407
Clinical Neuropsychologist
800 E 28TH ST STE 1750
MINNEAPOLIS, MN 55407
Physical Medicine & Rehabilitation
800 E 28TH ST STE 1750
MINNEAPOLIS, MN 55407
Physical Medicine & Rehabilitation
800 E 28TH ST STE 1750
MINNEAPOLIS, MN 55407

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 Dustin Brockberg's NPI number?

The NPI number for Dustin Brockberg is 1801422928. It was assigned to this individual provider in the NPPES registry on March 20, 2020.

Where is Dustin Brockberg located?

Dustin Brockberg practices at 800 E 28th St Ste 1750, Minneapolis, MN 55407. The listed phone number is (612) 863-4495.

What is Dustin Brockberg's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Dustin Brockberg enrolled in Medicare?

Yes. Dustin Brockberg 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.

When was this NPI record last updated?

The NPPES record for Dustin Brockberg was last updated on April 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.