Matthew Kingsbury, PSYD, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP6684 Issued in MN

Practice address

11316 86TH Ave N
Maple Grove, MN 55369-4528

Phone

(763) 400-8000

Fax

(763) 400-8000

NPI assigned

Dec 8, 2014

Last updated

Jul 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Parker Collins Family Mental Health PLLCGroup PAC ID 8325338031, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Parker Collins Family Mental Health, PLLC

  • Community/Behavioral Health Agency
  • Vadnais Heights, MN
  • NPI 1487927067
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1104224120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11316 86TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694528",
            "telephone_number": "763-400-8000",
            "fax_number": "651-426-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11316 86TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694528",
            "telephone_number": "763-400-8000",
            "fax_number": "763-400-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSBURY",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-08",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Elise Kieser, MS
• Miriam Yun-Mi Kim, M.D.
• Kind Herated Care LLC
• Jasmine King
• Kingdom Concierge Services LLC
• Jessica Jean Kirkpatrick, C.M.T.
• Matthew K Kissner, MD
• Mary Elizabeth Kleingarn
• Maren Elizabeth Kleopfer, PA-C
• Cynthia Kluver, LMFT

• Psychologist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.