Jonathan Gombola, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

50832 Issued in MN

Practice address

6401 France Ave S
Edina, MN 55435

Phone

(763) 559-3779

Fax

(763) 450-3986

NPI assigned

Jun 13, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Anesthesiology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southdale Anesthesiologists LLCGroup PAC ID 6709842461, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• M Health Fairview Southdale Hospital Hospital, Edina, MN, CCN 240078

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southdale Anesthesiologists, LLC

  • Anesthesiology Physician
  • Edina, MN
  • NPI 1154381804
  Medicare reassignment Care Compare group NPD

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

• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1699752915
  Care Compare affiliation
• Fairview Health Services

  • General Acute Care Hospital
  • Edina, MN
  • NPI 1932260833
  Care Compare affiliation

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527724800000",
    "number": "1881898955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14700 28TH AVE N STE 20",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474876",
            "telephone_number": "763-559-3779",
            "fax_number": "763-450-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6401 FRANCE AVE S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "763-559-3779",
            "fax_number": "763-450-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMBOLA",
        "first_name": "JONATHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2018-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "55760-20",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "50832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH INSURANCE",
            "identifier": "61154",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stanley Morton Goldberg, MD
• Daniel Goldman, PH.D.
• Davida Z. Goldman, PH.D., L.P.
• Maryann Goldstein, MD
• Bennett Ezra Goltz, P.A.-C
• Tao Gong, L.AC
• Cristina Marie Gonzalez Mendez, MD
• Miguel Gonzalez, PT
• Katherine Goodman, MSW, LICSW, LADC
• Sheila Rosenthal Goodman, M.D.

• Anesthesiology Physician in Edina, MN
• Providers in Edina, MN by specialty
• Anesthesiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.