Individual provider Active NPI

Jeffrey Ronald Gambach, MD

  • Diagnostic Radiology Physician
  • Robbinsdale, MN
National Provider Identifier
1558362947
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
46549 Issued in MN
Practice address
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone
(763) 559-2171
Fax
(763) 694-9000
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 46549 MN Primary
Diagnostic Ultrasound Physician 2085U0001X 46549 MN
Body Imaging Physician 2085B0100X 46549 MN

Addresses

Primary practice location

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926

Mailing address

2800 Campus Dr
#10
Plymouth, MN 55441-2645
Phone (763) 559-2171

Other identifiers 1

IdentifierTypeStateIssuer
714452100MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20040324000964 MN Practitioner - Diagnostic Radiology 2264323559 Reassigns benefits to 3 organizations
I20230328000086 WI Practitioner - Diagnostic Radiology 2264323559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Iowa, RJ & L Carver College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Imaging Partners LLCGroup PAC ID 1557734225, 29 clinicians
West Imaging LLCGroup PAC ID 7315833720, 29 clinicians
Minneapolis Radiology Associates LTDGroup PAC ID 5698661007, 44 clinicians
Minnesota Diagnostic Imaging Partners LLCGroup PAC ID 5890681209, 32 clinicians

Practice addresses (Care Compare)

2651 Hillcrest Dr
Suite 103
Hudson, WI 54016-9919
Phone (763) 559-2171

3366 Oakdale Ave N
Suite 604
Robbinsdale, MN 55422-2948
Phone (763) 398-6600

3366 Oakdale N Ave
Suite 604
Robbinsdale, MN 55422-5700
Phone (763) 398-6600

9855 Hospital Dr
Suite 150
Maple Grove, MN 55369-4776
Phone (763) 398-6341

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46549MNMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Imaging, LLC Diagnostic Radiology CurrentSince Oct 1, 2004 Accepting new patients
Hudson Imaging Partners LLC Diagnostic Radiology CurrentSince Jan 3, 2023 Accepting new patients
Minneapolis Radiology Associates, LTD. Body Imaging CurrentSince Jul 1, 2004 Accepting new patients
Minnesota Diagnostic Imaging Partners, LLC Diagnostic Radiology CurrentSince Dec 1, 2007 Accepting new patients

Locations

9855 Hospital Dr
Ste 150
Maple Grove, MN 55369
Phone (763) 398-6341

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000

2800 Campus Dr
Ste 30
Plymouth, MN 55441
Phone (763) 398-4000

2800 Campus Dr
Ste 20
Plymouth, MN 55441
Phone (763) 398-8700

2800 Campus Dr
Ste 10
Plymouth, MN 55441
Phone (763) 398-4400

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

3366 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5281

3366 Oakdale Ave N
Ste 604
Robbinsdale, MN 55422
Phone (763) 398-6600

3366 Oakdale Ave N
#604
Robbinsdale, MN 55422
Phone (763) 398-6600

2651 Hillcrest Dr
Ste 103
Hudson, WI 54016
Phone (763) 559-2171

Organizations & group practices 4

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1558362947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 CAMPUS DR",
            "address_2": "#10",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412645",
            "telephone_number": "763-559-2171",
            "fax_number": "763-694-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 OAKDALE AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222926",
            "telephone_number": "763-559-2171",
            "fax_number": "763-694-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBACH",
        "first_name": "JEFFREY",
        "middle_name": "RONALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "46549",
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "MN",
            "license": "46549",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MN",
            "license": "46549",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714452100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.