Active NPI
Maria De Lourdes Azevedo Gomes, MD
- Diagnostic Radiology Physician
- Robbinsdale, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 40553
- Practice address
- 3300 Oakdale Ave N
Robbinsdale, MN 55422-2926 - Phone
- (763) 559-2171
- Fax
- (763) 694-9000
- NPI assigned
- Jul 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 40553 | MN | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | 40553 | MN | |
| Body Imaging Physician | 2085B0100X | 40553 | MN | |
| Nuclear Radiology Physician | 2085N0904X | 40553 | MN |
Addresses
Primary practice location
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Mailing address
2800 Campus Dr
Ste 10
Plymouth, MN 55441-2645
Phone (763) 559-2171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 993017500 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Radiology
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2800 Campus Dr
Suite 10
Plymouth, MN 55441-2669
Phone (763) 559-2171
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 581-5400
9855 Hospital Dr
Suite 150
Maple Grove, MN 55369-4776
Phone (763) 398-6341
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 20 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40553 | MN | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Memorial Health Care | Current | Accepting new patients | |
| Minnesota Diagnostic Imaging Partners, LLC | Diagnostic Radiology | Current | Accepting new patients |
| West Imaging, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Hudson Imaging Partners LLC | Diagnostic Radiology | Current | Accepting new patients |
| Minneapolis Radiology Associates, LTD. | Body Imaging | Current | Accepting new patients |
| North Memorial Health Care | Current | Accepting new patients |
Locations
9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000
9855 Hospital Dr
Ste 150
Maple Grove, MN 55369
Phone (763) 398-6341
2955 Xenium Ln N
Ste 40
Plymouth, MN 55441
Phone (763) 398-2203
2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000
2800 Campus Dr
Ste 30
Plymouth, MN 55441
Phone (763) 398-4000
2800 Campus Dr
Ste 20
Plymouth, MN 55441
Phone (763) 398-8700
2800 Campus Dr
Ste 10
Plymouth, MN 55441
Phone (763) 398-4400
3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048
2651 Hillcrest Dr
Ste 103
Hudson, WI 54016
Phone (763) 559-2171
Organizations & group practices 6
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.
-
- Diagnostic Radiology Physician
- Robbinsdale, MN
- NPI 1871594341
Body Imaging
-
dba Maple Grove Imaging Center
- Diagnostic Radiology Physician
- Maple Grove, MN
- NPI 1922009471
-
dba North Memorial Health Hospital
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
-
dba Minneapolis Radiology-Robbinsdale
- Diagnostic Radiology Physician
- Robbinsdale, MN
- NPI 1053311399
-
- Diagnostic Radiology Physician
- Hudson, WI
- NPI 1346971371
-
- Clinic/Center
- Blaine, MN
- NPI 1841995552
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maple Grove, MN
- NPI 1225272552
-
dba North Memorial Ambulance Service
- Ambulance
- Brooklyn Center, MN
- NPI 1538195912
Hospital
-
dba North Memorial Health Specialty Center - Robbinsdale
- Medical Specialty Clinic/Center
- Robbinsdale, MN
- NPI 1699953000
Hospital
-
dba North Memorial Health Hospital
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340668800000",
"number": "1932109980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 CAMPUS DR",
"address_2": "STE 10",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554412645",
"telephone_number": "763-559-2171",
"fax_number": "763-694-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 OAKDALE AVE N",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222926",
"telephone_number": "763-559-2171",
"fax_number": "763-694-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMES",
"first_name": "MARIA",
"middle_name": "DE LOURDES AZEVEDO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-29",
"last_updated": "2012-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MN",
"license": "40553",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "MN",
"license": "40553",
"primary": false
},
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "MN",
"license": "40553",
"primary": false
},
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "MN",
"license": "40553",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "993017500",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Robbinsdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; 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.