Individual provider Active NPI

Margaret S Gorbatenko, MD

  • Psychiatry Physician
  • Minneapolis, MN
National Provider Identifier
1619026465
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
40465 Issued in MN
Practice address
1801 Nicollet Ave
Minneapolis, MN 55403-3793
Phone
(612) 348-9840
Fax
(612) 596-7900
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 40465 MN Primary

Addresses

Primary practice location

1801 Nicollet Ave
Minneapolis, MN 55403-3793

Mailing address

525 Portland Ave So.
HSB MC 952
Minneapolis, MN 55415
Phone (612) 348-9840

Other identifiers 1

IdentifierTypeStateIssuer
387524500MedicaidMN

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
I20110331000956 MN Practitioner - Psychiatry 4385827153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Minnesota Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

Practice addresses (Care Compare)

2215 E Lake St
Minneapolis, MN 55407-4385
Phone (612) 596-9438

Hospital & facility affiliations

  • Hennepin County Medical Center Hospital, Minneapolis, MN, CCN 240004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40465MNMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin County Psychiatry CurrentSince Oct 1, 1999 Accepting new patients
Hennepin County CurrentSince Oct 1, 1999 Accepting new patients
Hennepin County Past Accepting new patients

Locations

1801 Nicollet Ave
Minneapolis, MN 55403
Phone (612) 596-0900

525 Portland Ave
#952
Minneapolis, MN 55415
Phone (612) 348-9840

2215 E Lake St
Minneapolis, MN 55407
Phone (612) 596-0900

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1619026465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE SO.",
            "address_2": "HSB MC 952",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55415",
            "telephone_number": "612-348-9840",
            "fax_number": "612-596-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033793",
            "telephone_number": "612-348-9840",
            "fax_number": "612-596-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORBATENKO",
        "first_name": "MARGARET",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "40465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387524500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.