BLAKE KATHLEEN GOMEZ CPNP-AC
NPI 1447723796
Nurse Practitioner - Pediatrics in Minneapolis, MN

Q: What is Blake Gomez's NPI number?

The NPI number for Blake Gomez is 1447723796. It was assigned to this individual provider in the NPPES registry on January 9, 2019. The provider is also known as Blake Kathleen Wincentsen.

Q: What is Blake Gomez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Blake Gomez was last updated on May 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 January 09, 2019PECOS Enrolled

2525 CHICAGO AVE, MINNEAPOLIS, MN 55404(612) 813-7888(612) 813-6361 Get Directions Write a Review

NPPES record last updated: May 26, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 26, 2021, Jan 9, 2019 (2 updates tracked since 2019).

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About Blake Kathleen Gomez Cpnp-ac NPPES

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

BLAKE KATHLEEN GOMEZ CPNP-AC (NPI 1447723796) is an individual pediatrics provider in Minneapolis, Minnesota, licensed in Minnesota (8198) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1447723796

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameBLAKE KATHLEEN GOMEZCredential: CPNP-AC

Location Address2525 CHICAGO AVEMinneapolis, MN 55404-4518

Mailing Address10860 Kingsborough TrlCottage Grove, MN 55016-4660 · (651) 769-5002

Phone(612) 813-7888

Fax(612) 813-6361

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJanuary 9, 2019

Last NPPES UpdateMay 26, 20212 updates tracked since enumeration

NPPES CertifiedMay 26, 2021

✔ NPI 1447723796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in MN · 8198

Also ListedNurse Practitioner · Pediatrics, Critical CareTaxonomy 363LP0222X · License 209018598 (IL)

2525 CHICAGO AVE, Minneapolis, MN 55404

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Other Names 1

Former Name (1)Blake Kathleen Wincentsen

Secondary Practice Locations 3

Location 14400 W 95th StOak Lawn, IL 60453-2654 · Phone (708) 684-8000

Location 21675 Dempster StPark Ridge, IL 60068-1110 · Phone (855) 312-5437

Location 3345 Smith Ave NSaint Paul, MN 55102-2346 · Phone (612) 813-7888 · Fax (612) 813-6361

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)

Blake Kathleen Gomez Cpnp-ac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577803477

PECOS Enrollment IDI20210712001258

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 55404 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.

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