GRAYSON W BLOMBERG PA-C
NPI 1003057118
Physician Assistant - Surgical in Plymouth, MN

Q: What is Grayson Blomberg's NPI number?

The NPI number for Grayson Blomberg is 1003057118. It was assigned to this individual provider in the NPPES registry on March 19, 2009.

Q: What is Grayson Blomberg's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Grayson Blomberg was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 19, 2009PECOS EnrolledAccepts Medicare Assignment

15700 37TH AVE N STE 150, PLYMOUTH, MN 55446(651) 968-5201 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Aug 16, 2017, Dec 29, 2015 (3 updates tracked since 2015).

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About Grayson W Blomberg Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAYSON W BLOMBERG PA-C (NPI 1003057118) is an individual surgical provider in Plymouth, Minnesota, licensed in Minnesota (10560) and active in the NPI registry since March 2009. He is enrolled in Medicare PECOS, is affiliated with Abbott Northwestern Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1003057118

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameGRAYSON W BLOMBERGCredential: PA-C

Location Address15700 37TH AVE N STE 150Plymouth, MN 55446-3675

Mailing Address710 Commerce Dr Ste 200Woodbury, MN 55125-4925 · (651) 968-5201

Phone(651) 968-5201

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateMarch 19, 2009

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

✔ NPI 1003057118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in MN · 10560

15700 37TH AVE N STE 150, Plymouth, MN 55446

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Grayson W Blomberg Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668520354

PECOS Enrollment IDI20090507000320

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

40 services38 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

23 services13 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

18 services17 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

16 services15 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

13 services13 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Abbott Northwestern Hospital

Acute Care Hospitals · Minneapolis, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240057

Location800 East 28th StreetMinneapolis, MN 55407 · Hennepin County

Emergency services Birthing friendly

M Health Fairview Southdale Hospital

Acute Care Hospitals · Edina, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240078

Location6401 France Avenue SouthEdina, MN 55435 · Hennepin County

Emergency services Birthing friendly

Maple Grove Hospital

Acute Care Hospitals · Maple Grove, MN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240214

Location9875 Hospital DriveMaple Grove, MN 55369 · Hennepin County

Emergency services Birthing friendly

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN M ROZMAN FNP

Nurse Practitioner (Family)