NPIMap

Individual provider Active NPI

Paul Bloomberg, MD

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1902878010
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
32585 Issued in MN
Practice address
4730 Chicago Ave
Minneapolis, MN 55407-3570
Phone
(952) 883-6805
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32585 MN Primary

Addresses

Primary practice location

4730 Chicago Ave
Minneapolis, MN 55407-3570

Mailing address

8170 33Rd Ave S
Bloomington, MN 55425-4516
Phone (952) 883-6805

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
I20100306000351 MN Practitioner - Internal Medicine 2365587920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Vermont College of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

1650 Beam Ave
Maplewood, MN 55109-1192
Phone (651) 221-4316

1655 Beam Ave
Maplewood, MN 55109-1163
Phone (651) 232-7780

2017 Woodlynn Ave
Suite 32
Maplewood, MN 55109-1417
Phone (866) 434-2597

2165 White Bear Ave
Maplewood, MN 55109-2707
Phone (651) 770-8828

2312 S 6TH St
Minneapolis, MN 55454-1336
Phone (612) 672-6000

2375 Skillman E Ave
N Saint Paul, MN 55109-4047
Phone (651) 777-7435

2512 S 7TH St
Minneapolis, MN 55454-1404
Phone (612) 273-4277

2688 Maplewood Dr
Maplewood, MN 55109-1021
Phone (651) 254-8150

Hospital & facility affiliations

  • Presbyterian Homes Hospice Inc Hospice, Roseville, MN, CCN 241589
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Gables of Boutwells Landing Nursing home, Oak Park Heights, MN, CCN 245615
  • Presbyterian Homes of Bloomington Nursing home, Bloomington, MN, CCN 245556
  • Maplewood Rehabilitation Center Nursing home, Maplewood, MN, CCN 245276

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Mar 8, 2019 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health Plan Inc CurrentSince Jan 1, 1998 Accepting new patients
Park Nicollet Clinic Current Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 1998 Accepting new patients
Park Nicollet Clinic CurrentSince Mar 8, 2019 Accepting new patients
Presbyterian Homes Bloomington Care Center, Inc Past Accepting new patients
Maplewood Rehabilitation Center LLC Past Accepting new patients
Vssa Care Center LLC Past Accepting new patients

Locations

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8170 33rd Ave S
Minneapolis, MN 55425
Phone (952) 883-5463

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

4730 Chicago Ave
Minneapolis, MN 55407
Phone (612) 313-0000

2165 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 523-9800

Organizations & group practices 9

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 6

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1902878010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073570",
            "telephone_number": "952-883-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMBERG",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "32585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.