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Deactivated NPI 1114989936 Deactivated / Inactive NPI Male Practitioner

Dr. Gregory Peter Bambenek , MD

Specialist • Duluth, MN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Gregory Bambenek has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 05, 2006
NPI Deactivation Date May 15, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Gregory Bambenek, MD was a registered Specialist practicing in Duluth, MN. Throughout an active medical career spanning 19 years, Dr. Bambenek provided care at the practice location at 314 W SUPERIOR ST until profile deactivation on 2025-05-15.

Practice Location & Contact Primary Location

Practice Address

314 W Superior St
Ste 902

Duluth, MN 558021805

Telephone 2187274531
Fax 2187274211
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Duluth, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 35.0 Yrs
State Avg: 34.7 Yrs
Regional Practice Density
16 Specialists

Practicing in Duluth, MN (877 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License MN 23158

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
NPI 1356466924

Master of Arts, Licensed Psychologist

Cheryl Graham , MSW, LICSW

Social Worker - Clinical

NPI 1588789390

Master of Social Work, Licensed Independent Clinical Social Worker

NPI 1588794598

Master of Arts, Licensed Psychologist

NPI 1598895591

Master of Arts, Licensed Psychologist

Heather Rappana , MSW, LICSW

Social Worker - Clinical

NPI 1669599809

Master of Social Work, Licensed Independent Clinical Social Worker

Dr. Andrine Lemieux , PhD, LP

Clinical Neuropsychologist

NPI 1750537874

Doctor of Philosophy (Ph.D.), Licensed Psychologist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 15, 2025

Record deactivated on May 15, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 314 W SUPERIOR ST, STE 902, DULUTH, MN 558021805 (Tel: 2187274531)

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Updated Business Mailing Address July 08, 2007

Registered at 5130 LONDON RD, DULUTH, MN 558042400 (Tel: 2185256201)

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Provider Name / Credentials Updated July 08, 2007

Recorded as GREGORY BAMBENEK, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist (License #23158 in MN)

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Initial NPI Registration & Enumeration April 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114989936
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 05, 2006
Last Update: July 08, 2007
Deactivation Date: May 15, 2025

Mailing Address

5130 London Rd

Duluth, MN 558042400

Phone: 2185256201

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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