Individual provider Active NPI

David Alois Praska Jr., MA, LMFT

  • Marriage & Family Therapist
  • Bloomington, MN
National Provider Identifier
1053839928
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4265 Issued in MN
Practice address
1101 E 78TH St Ste 100
Bloomington, MN 55420-1402
Phone
(952) 854-5034
Fax
(952) 854-5363
NPI assigned
Aug 31, 2017
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4265 MN Primary

Addresses

Primary practice location

1101 E 78TH St Ste 100
Bloomington, MN 55420-1402

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

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
I20231227002899 MN Practitioner - Marriage and Family Therapist 0749630143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

1101 E 78TH St
Suite 100
Bloomington, MN 55420-1402
Phone (651) 604-3280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4265MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates, LTD Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
Family Prospective Resources, Inc Marriage & Family Therapist Past Accepting new patients
Family Support Services Inc. Mental Health PastSince May 1, 2022 Accepting new patients

Locations

1101 E 78th St
Ste 100
Minneapolis, MN 55420
Phone (952) 234-8604

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

Organizations & group practices 3

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1053839928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E 78TH ST STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554201402",
            "telephone_number": "952-854-5034",
            "fax_number": "952-854-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRASKA",
        "first_name": "DAVID",
        "middle_name": "ALOIS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "4265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

Verify at the official NPI Registry.