Laura Ann Gonshorowski

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12354 Issued in MN

Practice address

2720 Faiview Avenue N
Suite 100
Roseville, MN 55113

Phone

(651) 241-5290

Fax

(651) 241-5248

NPI assigned

Feb 21, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Childrens Health Care

  • Pediatrics Physician
  • Minneapolis, MN
  • NPI 1932208808

  MN

  Medicare reassignment
• Childrens Health Care

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1689778912
  NPD
• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD
• Childrens Health Care

  • Children's Hospital
  • Saint Paul, MN
  • NPI 1629161781
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1477092690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 FAIVIEW AVE N",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-241-5290",
            "fax_number": "651-241-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 FAIVIEW AVENUE N",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-241-5290",
            "fax_number": "651-241-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSHOROWSKI",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Maureen Glembocki, MD
• Grady Glynn, DPT
• James K Goddard III, MD
• Timothy C Goertzen, MD
• Golden Healthcare Service LLC
• Karalyn Goodyear
• Cimena Gordon, LICSW
• Gorman Optical Inc
• Ibrahim Rashid Goro
• Grace Home Health LLC

• All providers in Roseville, MN
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.

Verify at the official NPI Registry.