Individual provider Active NPI

Gerilyn A Erkkila, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1053371476
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13763 Issued in MN
Practice address
69 Exchange St W
Saint Paul, MN 55102-1004
Phone
(651) 232-3000
NPI assigned
Mar 28, 2006
Last updated
Jan 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13763 MN Primary

Addresses

Primary practice location

69 Exchange St W
Saint Paul, MN 55102-1004

Mailing address

69 Exchange St W
Saint Paul, MN 55102-1004
Phone (651) 232-3000

Other identifiers 1

IdentifierTypeStateIssuer
316538800MedicaidMN

Other names 1

  • Gerilyn A Manderfield Former name

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
I20040720000964 MN Practitioner - Clinical Social Worker 3678553872 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

45 W 10TH St
Suite 3000
St Paul, MN 55102-1062
Phone (651) 326-4800

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13763MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Jan 1, 2021 Accepting new patients
Healtheast St. John's Hospital CurrentSince Dec 1, 2020 Accepting new patients
Healtheast Medical Research Institute Clinical CurrentSince Mar 16, 2010 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Mar 16, 2010 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2021 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients

Locations

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1983 Sloan Pl
Ste 1
Saint Paul, MN 55117
Phone (651) 326-5700

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

45 10th St W
Ste 3000
Saint Paul, MN 55102
Phone (651) 232-3000

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

980 Rice St
Saint Paul, MN 55117
Phone (651) 326-9020

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1053371476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 EXCHANGE ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021004",
            "telephone_number": "651-232-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 EXCHANGE ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021004",
            "telephone_number": "651-232-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERKKILA",
        "first_name": "GERILYN",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "316538800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GERILYN",
            "last_name": "MANDERFIELD",
            "middle_name": "A",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.