NPIMap

Individual provider Active NPI

Mayra G Oberto-Medina, DO

  • Rheumatology Physician
  • Coon Rapids, MN
National Provider Identifier
1790738185
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
48504 Issued in MN
Practice address
9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841
Phone
(763) 780-9155
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 48504 MN Primary

Addresses

Primary practice location

9055 Springbrook Dr NW
Coon Rapids, MN 55433-5841

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

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
I20061031000376 MN Practitioner - Internal Medicine 8820095078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-5200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute CurrentSince Aug 27, 2012 Accepting new patients
North Memorial Health Care Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
North Memorial Health Care CurrentSince Jun 15, 2017 Accepting new patients
Healtheast Medical Research Institute CurrentSince Aug 27, 2012 Accepting new patients
Allina Health System Past Accepting new patients
North Memorial Health Care Past Accepting new patients

Locations

4181 108th Ave NE
Blaine, MN 55449
Phone (763) 581-0555

11855 Ulysses St NE
Ste 110
Blaine, MN 55434
Phone (763) 235-4104

480 Osborne Rd NE
Ste 100
Minneapolis, MN 55432
Phone (763) 785-4500

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

17 Exchange St W
Ste 835
Saint Paul, MN 55102
Phone (651) 232-4200

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: mobertomedina127869@direct.northmemorial.com

Organizations & group practices 8

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 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1790738185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9055 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335841",
            "telephone_number": "763-780-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERTO-MEDINA",
        "first_name": "MAYRA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MN",
            "license": "48504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

Verify at the official NPI Registry.