Individual provider Active NPI

Daniel L Legerski, PSY D LP

  • Clinical Psychologist
  • Edina, MN
National Provider Identifier
1083796916
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4384 Issued in MN
Practice address
5200 Willson Rd
Suite 205
Edina, MN 55424-1343
Phone
(952) 200-9804
Fax
(952) 920-2461
NPI assigned
Oct 19, 2006
Last updated
Dec 9, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP4384 MN Primary

Addresses

Primary practice location

5200 Willson Rd
Suite 205
Edina, MN 55424-1343

Mailing address

5200 Willson Rd
Suite 205
Edina, MN 55424-1343
Phone (952) 200-9804

Other identifiers 1

IdentifierTypeStateIssuer
156798500MedicaidMN

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
I20070105000084 MN Practitioner - Clinical Psychologist 3375543994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5200 Willson Rd
Suite 205
Edina, MN 55424-1343
Phone (952) 200-9804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP4384MNMDClinical Psychologist
4384MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Legerski, Psy.D., LP, LLC Clinical CurrentSince Jun 2, 2009 Accepting new patients
Bhsi, LLC Clinical PastSince Oct 10, 2012 Accepting new patients

Locations

5200 Willson Rd
Ste 205
Minneapolis, MN 55424
Phone (612) 875-4449

Organizations & group practices 2

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291852800000",
    "number": "1083796916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD",
            "address_2": "SUITE 205",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241343",
            "telephone_number": "952-200-9804",
            "fax_number": "952-920-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD",
            "address_2": "SUITE 205",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241343",
            "telephone_number": "952-200-9804",
            "fax_number": "952-920-2461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGERSKI",
        "first_name": "DANIEL",
        "middle_name": "L",
        "credential": "PSY D LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2010-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156798500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.