Individual provider Active NPI

Juihsien Hung Kao

  • Clinical Psychologist
  • Fridley, MN
National Provider Identifier
1013402429
Registry record updated Mar 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5508 Issued in MN
Practice address
7362 University Ave NE Ste 209
Fridley, MN 55432-3151
Phone
(612) 400-7914
Fax
(612) 464-6595
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 5508 MN
Clinical Psychologist 103TC0700X 5508 MN Primary

Addresses

Primary practice location

7362 University Ave NE Ste 209
Fridley, MN 55432-3151

Mailing address

7362 University Ave NE Ste 209
Fridley, MN 55432-3151
Phone (612) 400-7914

Other practice location 1

3101 Superior Dr NW
Rochester, MN 55901-1993
Phone (507) 288-8544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180927000905 MN Practitioner - Clinical Psychologist 9830440015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Minnesota Medical School, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7362 University Ave NE
Suite 209
Fridley, MN 55432-3151
Phone (612) 400-7914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Juihsien Kao, PHD, LP PLLC Psychologist CurrentSince Mar 27, 2023 Accepting new patients

Locations

7362 University Ave NE
Ste 209
Minneapolis, MN 55432
Phone (612) 400-7914

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22840/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679788800000",
    "number": "1013402429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7362 UNIVERSITY AVE NE STE 209",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323151",
            "telephone_number": "612-400-7914",
            "fax_number": "612-464-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7362 UNIVERSITY AVE NE STE 209",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554323151",
            "telephone_number": "612-400-7914",
            "fax_number": "612-464-6595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 Superior Dr NW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559011993",
            "country_code": "US",
            "telephone_number": "507-288-8544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAO",
        "first_name": "JUIHSIEN",
        "middle_name": "HUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2023-03-26",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "5508",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "5508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.