Brent D Plackner, PA-C is a
Physician Assistant based in Bayport, Minnesota. Brent D Plackner is licensed to practice in Minnesota (license number 11906) and his current practice location is
970 Pickett St N, Bayport, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(651) 779-5713.
NPI number for Brent D Plackner is 1487647996 and his current mailing address is 2277 Highway 36 W Ste 140, Roseville, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1487647996.
Provider's Profile
| Full Name | Brent D Plackner |
|---|
| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 970 Pickett St N, Bayport, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1487647996
- Provider Enumeration Date: 08/30/2005
- Last Update Date: 01/19/2018
Medical Identifiers
Medical identifiers for Brent D Plackner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1487647996 | NPI | - | NPPES |
| 004156125 | Other | WI | MEDICARE NUMBER |
| 42958400 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 865-23 (Wisconsin) | Secondary |
| 363A00000X | Physician Assistant | 11906 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brent D Plackner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brent D Plackner, PA-C
2277 Highway 36 W Ste 140,
Roseville, MN 55113-3895
Ph: (612) 255-0628 | Brent D Plackner, PA-C
970 Pickett St N,
Bayport, MN 55003-1489
Ph: (651) 779-5713 |
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