Michael T. Hill, PH.D.
Individual provider Active NPI Psychologist · Bagley, MN
NPI 1104155175 · NPPES record last updated Oct 2, 2019
Key facts
- NPI
- 1104155175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- LP5479 (MN)
- Practice address
- 1656 Central St W
Bagley, MN 56621 - Phone
- (218) 694-2384
- Fax
- (218) 694-6687
- NPI assigned
- Dec 21, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 22
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sanford Health of Northern Minnesota
Practice addresses (Care Compare)
1656 Central St W
Bagley, MN 56621-4357
Phone (218) 694-2384
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120615000561 | MN | Practitioner - Clinical Psychologist | 4587828819 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP5479 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health of Northern Minnesota | Current |
Accepting new patients | |
| Sanford Health of Northern Minnesota | Current |
Accepting new patients | |
| Sanford Health of Northern Minnesota | Current | Accepting new patients | |
| Jean C. Christensen | Past | Accepting new patients |
Locations
203 4th St NW
Bagley, MN 56621
Phone (218) 694-3939
1656 Central St W
Bagley, MN 56621
Phone (218) 694-2384
1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Psychologist | 103T00000X | LP5479 | MN | Yes |
Addresses
Primary practice location
1656 Central St W
Bagley, MN 56621
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (218) 694-2384
Other practice location 1
722 15th St NW
Bemidji, MN 56601
Phone (218) 751-3280
Other providers in Bagley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2019. 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.