NPIMap

Individual provider Active NPI

Thomas B Koenig, M.D.

  • Gastroenterology Physician
  • Robbinsdale, MN
National Provider Identifier
1760419741
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
39494 Issued in MN
Practice address
3366 Oakdale Ave N
Suite 315
Robbinsdale, MN 55422-2948
Phone
(763) 520-7900
Fax
(763) 520-7989
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 39494 MN Primary

Addresses

Primary practice location

3366 Oakdale Ave N
Suite 315
Robbinsdale, MN 55422-2948

Mailing address

3366 Oakdale Ave N
Suite 315
Robbinsdale, MN 55422
Phone (763) 520-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100910001090 MN Practitioner - Gastroenterology 9537256706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Creighton University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mngi Digestive Health PAGroup PAC ID 8123016557, 276 clinicians

Practice addresses (Care Compare)

9145 Springbrook Dr NW
Suite 200
Coon Rapids, MN 55433-5886
Phone (612) 871-1145

Hospital & facility affiliations

  • Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214
  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
  • Mercy Hospital Hospital, Coon Rapids, MN, CCN 240115

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy39
Upper gastrointestinal (GI) endoscopy for acid reflux67

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39494MNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Clinic, PA Current Accepting new patients
Mngi Digestive Health, P.a. Gastroenterology CurrentSince Dec 4, 2018 Accepting new patients
North Memorial Endoscopy Center at Maple Grove, LLC PastSince Dec 3, 2007 Accepting new patients
North Clinic, PA Past Accepting new patients

Locations

9145 Springbrook Dr NW
Ste 200
Coon Rapids, MN 55433
Phone (612) 625-8999

9855 Hospital Dr
Ste 104
Maple Grove, MN 55369
Phone (763) 581-5900

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

9855 Hospital Dr
Ste 102B
Maple Grove, MN 55369
Phone (763) 581-5600

50 Central Ave
Osseo, MN 55369
Phone (612) 588-4625

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

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

3366 Oakdale Ave N
Ste 315
Robbinsdale, MN 55422
Phone (763) 520-7900

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: thomas.koenigmd.p1@direct.mngastro.nextgenshare.com

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760419741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N",
            "address_2": "SUITE 315",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "763-520-7900",
            "fax_number": "763-520-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N",
            "address_2": "SUITE 315",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222948",
            "telephone_number": "763-520-7900",
            "fax_number": "763-520-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "THOMAS",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MN",
            "license": "39494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

Verify at the official NPI Registry.