Individual provider Active NPI

Eric Morris Bomberg, M.D.

  • Pediatric Endocrinology Physician
  • Minneapolis, MN
National Provider Identifier
1578880746
Registry record updated Aug 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
54359 Issued in MN
Practice address
2512 S 7TH St
Minneapolis, MN 55454
Phone
(612) 365-6777
NPI assigned
Apr 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Endocrinology Physician 2080P0205X 54359 MN Primary

Addresses

Primary practice location

2512 S 7TH St
Minneapolis, MN 55454

Mailing address

2512 S 7TH St
Minneapolis, MN 55454-1404
Phone (612) 365-6777

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120531000239 MN Practitioner - EndocrinologyPractitioner - General PracticePractitioner - Pediatric Medicine 0749443760 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Pediatric Medicine
Education
University of Southern California Keck School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54359MNMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services CurrentSince Jul 24, 2018 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jul 31, 2018 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 31, 2018 Accepting new patients
University of Minnesota Physicians CurrentSince Jul 31, 2018 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jul 31, 2018 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Clinics CurrentSince Jul 24, 2018 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Cardiothoracic Surgery Clinic of North Ms Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2512 S 7th St
Minneapolis, MN 55454
Phone (612) 273-4277

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

Interoperability endpoints

  • Direct secure messaging: ebomberg100705@fairview.direct-ci.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1578880746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 S 7TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541404",
            "telephone_number": "612-365-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 S 7TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55454",
            "telephone_number": "612-365-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBERG",
        "first_name": "ERIC",
        "middle_name": "MORRIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MN",
            "license": "54359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.