Ricci Lee Bender, MD
Individual provider Active NPI Psychiatry Physician · Duluth, MN
NPI 1063945665 · NPPES record last updated Jul 19, 2021
Key facts
- NPI
- 1063945665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 69478 (MN)
- Practice address
- 502 E 2ND St
Duluth, MN 55805-1913 - Phone
- (218) 786-8364
- NPI assigned
- Apr 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 25
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- University of Minnesota Medical School, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- The Duluth Clinic LTD
Practice addresses (Care Compare)
502 E 2ND St
Duluth, MN 55805-1913
Phone (218) 786-8364
Hospital & facility affiliations
- Essentia Health Duluth
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210730003164 | MN | Practitioner - Psychiatry | 6800160250 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63713 | CT | MD | Psychiatry Physician |
| 69478 | MN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Duluth Clinic, LTD. | Current |
Accepting new patients | |
| The Duluth Clinic LTD | Current | Accepting new patients | |
| The Duluth Clinic, LTD | Current |
Accepting new patients |
Locations
502 E 2nd St
Duluth, MN 55805
Phone (218) 727-8762
400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 63713 | CT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 69478 | MN | Yes |
Addresses
Primary practice location
502 E 2ND St
Duluth, MN 55805-1913
Mailing address
400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364
Other providers in Duluth, MN
- William Jay Bellamy
- Gerald J Bellehumeur
- Courtney Bellmore
- Belongings, LLC
- Bridget Mary Bemis
- Benedictine Care Centers
- Benedictine Health Center
- Benedictine Sisters Benevolent Association
- Joseph Benert
- Mishell De Los Angeles Benitez Suarez
All providers in Duluth, MN · Psychiatry Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.