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DR. MARY C BLOMBERG MD
NPI 1205813557
Pediatrics in St Louis Park, MN

Active since December 28, 2005PECOS Enrolled
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416(952) 993-3298 Get Directions Write a Review

NPPES record last updated: June 27, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Mary C Blomberg Md NPPES

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

DR. MARY C BLOMBERG MD (NPI 1205813557) is an individual pediatrics provider in St Louis Park, Minnesota, licensed in Minnesota (41144) and active in the NPI registry since December 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205813557
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. MARY C BLOMBERGCredential: MD
Location Address3850 PARK NICOLLET BLVDSt Louis Park, MN 55416-2527
Mailing Address6465 Wayzata Blvd, Ste 315St Louis Park, MN 55426-1728
Phone(952) 993-3298
Sole ProprietorNo
Enumeration DateDecember 28, 2005
Last NPPES UpdateJune 27, 2012
✔ NPI 1205813557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MN · 41144
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3850 PARK NICOLLET BLVD, St Louis Park, MN 55416
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Other Identifiers 3

Medicaid753224500MN
Medicare UPING89806MN
Medicare ID-Type UnspecifiedG89806MN

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mary C Blomberg Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55416 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

ELISABETH JEAN MCCLEAN MD
Family Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 883-1000
AMY VANDENBERG PA-C
Physician Assistant
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 883-1000
KELSEY WIDMYER ISRAELSON PA
Physician Assistant
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 883-1000
KARI MILLER
Family Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-3512
SARAH EVERT
Internal Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-3025
DR. WAYNE D LIEBHARD M.D.
Family Medicine
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-3025
PATRICK MUELLER
Pediatrics
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-3298
PARK NICOLLET HEALTH CARE PRODUCTS
Durable Medical Equipment & Medical Supplies
3850 PARK NICOLLET BLVD
ST LOUIS PARK, MN 55416
Hennepin County (952) 993-1330

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Blomberg's NPI number?

The NPI number for Mary Blomberg is 1205813557. It was assigned to this individual provider in the NPPES registry on December 28, 2005.

Where is Mary Blomberg located?

Mary Blomberg practices at 3850 Park Nicollet Blvd, St Louis Park, MN 55416. The listed phone number is (952) 993-3298.

What is Mary Blomberg's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mary Blomberg enrolled in Medicare?

Yes. Mary Blomberg is registered in the Medicare PECOS enrollment system.

What insurance does Mary Blomberg accept?

Health plans from HealthPartners and Medica list Mary Blomberg as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mary Blomberg was last updated on June 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.