David Gordon Drake, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

30429 Issued in MN

Practice address

2355 Highway 36 W Ste 100
Roseville, MN 55113-3905

Phone

(651) 292-2000

Fax

(651) 292-2204

NPI assigned

Jan 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN, CA, WI, ND4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Diagnostic Radiology

Education

University of Minnesota Medical School, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Radiology PAGroup PAC ID 4486568482, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gillette Childrens Specialty Hospital Hospital, Saint Paul, MN, CCN 243300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations (25 of 59)

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.

• Midwest Radiology, PA

  • Diagnostic Radiology Physician
  • Roseville, MN
  • NPI 1952307175

  CA, WI

  Medicare reassignment Care Compare group NPD
• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Allina Health System

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD
• Altru Health System

  • Clinic/Center
  • Crookston, MN
  • NPI 1760494330
  Medicare reassignment NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Fairview Express Care

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Grand Itasca Clinic and Hospital

  • General Acute Care Hospital
  • Grand Rapids, MN
  • NPI 1669426631
  Medicare reassignment NPD
• Lac Qui Parle Clinic of Madison Inc

  • Rural Health Clinic/Center
  • Madison, MN
  • NPI 1144266156
  Medicare reassignment NPD
• Madison Healthcare Services

  • Critical Access Hospital
  • Madison, MN
  • NPI 1942246848

  CA

  Medicare reassignment NPD
• Midwest Radiology Outpatient Imaging, LLC

  • Diagnostic Radiology Physician
  • Saint Paul, MN
  • NPI 1720059264
  Medicare reassignment NPD
• Range Regional Health Services

  • Clinic/Center
  • Hibbing, MN
  • NPI 1669569265
  Medicare reassignment NPD
• Ridgeview Medical Center

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Gillette Children'S Specialty Healthcare

  • Customized Equipment (DME)
  • Mankato, MN
  • NPI 1295145902

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Children's Hospital
  • Saint Paul, MN
  • NPI 1447352836
  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1477612604

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Minnetonka, MN
  • NPI 1598824880

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Maple Grove, MN
  • NPI 1730363698

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Burnsville, MN
  • NPI 1740349042

  Hospital

  Care Compare affiliation
• Gillette Children'S Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1851450894

  Hospital

  Care Compare affiliation
• Gillette Childrens Specialty Healthcare

  • Multi-Specialty Clinic/Center
  • Saint Paul, MN
  • NPI 1760541700

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1528046612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000",
            "fax_number": "651-292-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 100",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "651-292-2000",
            "fax_number": "651-292-2204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 4th St E",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551011421",
            "country_code": "US",
            "telephone_number": "651-292-2043",
            "fax_number": "651-292-2204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "DAVID",
        "middle_name": "GORDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "30429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199387900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan Mackenzie Donald, MD
• Donna Anderson Licsw, PA
• Stephanie Maryann Donnelly, CRNA
• Robert C Doss, PSYD LP
• Dove Inc.
• Michelle Dreshar
• Megan Marie Drewianka, CNP
• Rebecca Driessen, MD
• Regina M Driscoll, PHD LP
• Madeeha Drissi, MD

• Diagnostic Radiology Physician in Roseville, MN
• Providers in Roseville, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.