Blake Kathleen Gomez, CPNP-AC - Medicare Nurse Practitioner in Minneapolis, MN

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Blake Kathleen Gomez, CPNP-AC is a medicare enrolled "Nurse Practitioner - Pediatrics" in Minneapolis, Minnesota. Her current practice location is 2525 Chicago Ave, Minneapolis, Minnesota. You can reach out to her office (for appointments etc.) via phone at (612) 813-7888.

Blake Kathleen Gomez is licensed to practice in Minnesota (license number 8198) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1447723796.

Contact Information

Blake Kathleen Gomez, CPNP-AC
2525 Chicago Ave,
Minneapolis, MN 55404-4518
(612) 813-7888
(612) 813-6361

Map and Direction




Provider's Profile

Full NameBlake Kathleen Gomez
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location2525 Chicago Ave, Minneapolis, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1447723796
  • Provider Enumeration Date: 01/09/2019
  • Last Update Date: 05/26/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 3577803477
  • Enrollment ID: I20210712001258

Medical Identifiers

Medical identifiers for Blake Kathleen Gomez such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1447723796NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0222XNurse Practitioner - Pediatrics, Critical Care 209018598 (Illinois)Secondary
363LP0200XNurse Practitioner - Pediatrics 8198 (Minnesota)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Blake Kathleen Gomez allows following entities to bill medicare on her behalf.
Entity NameChildren's Health Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932208808
PECOS PAC ID: 2668370966
Enrollment ID: O20040406000939

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Blake Kathleen Gomez is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Blake Kathleen Gomez, CPNP-AC
10860 Kingsborough Trl,
Cottage Grove, MN 55016-4660

Ph: (651) 769-5002		Blake Kathleen Gomez, CPNP-AC
2525 Chicago Ave,
Minneapolis, MN 55404-4518

Ph: (612) 813-7888

Reviews and Comments


Nurse Practitioner Nurses in Minneapolis, MN

Shiao-lin D Hui,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 920 2nd Ave S, Suite 400, Minneapolis, MN 55402
Phone: 612-659-7111    Fax: 612-659-7101
Deborah Elkins,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 920 2nd Ave S, Suite 400, Minneapolis, MN 55402
Phone: 612-225-1534    
Anne Hawkins,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2530 Chicago Ave, Csc 390, Minneapolis, MN 55404
Phone: 612-813-6102    
Mrs. Mary Susan Clipp, CPNP-AC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2450 Riverside Ave, Minneapolis, MN 55454
Phone: 612-365-3100    Fax: 612-365-3110
Derek Przybylski,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2525 Chicago Ave, Minneapolis, MN 55404
Phone: 715-207-9330    
Dr. Kenneth Mcrae, DNP, APRN, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 2925 Chicago Ave, Minneapolis, MN 55407
Phone: 763-236-5000    
Hannah L. Balfanz, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 814 South 3rd Street, Minneapolis, MN 55415
Phone: 612-888-9792    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.