Active NPI
Anna G. Rakovshik, MD
- Pediatrics Physician
- Plymouth, MN
National Provider Identifier
1194772319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 56694
- Practice address
- 4155 County Road 101 N
Plymouth, MN 55446-2307 - Phone
- (952) 993-8900
- NPI assigned
- May 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 47934 | WI | |
| Pediatrics Physician | 208000000X | 56694 | MN | Primary |
Addresses
Primary practice location
4155 County Road 101 N
Plymouth, MN 55446-2307
Mailing address
8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 348482000 | Medicaid | WI |
Other names 1
- Ms. Anna Golod
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47934 | WI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Pediatrics | Current | Accepting new patients |
| Park Nicollet Clinic | Pediatrics | Current | Accepting new patients |
Locations
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
4155 County Road 101 N
Plymouth, MN 55446
Phone (952) 977-3000
3007 Harbor Ln N
Plymouth, MN 55447
Phone (612) 439-4650
Interoperability endpoints
- arakovshik153215@direct.healthpartners.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615852800000",
"number": "1194772319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S # MS 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4155 COUNTY ROAD 101 N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554462307",
"telephone_number": "952-993-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAKOVSHIK",
"first_name": "ANNA",
"middle_name": "G.",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-31",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WI",
"license": "47934",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "56694",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "348482000",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANNA",
"last_name": "GOLOD",
"prefix": "MS.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.