Organization Active NPI

Martin J. Schoen, Psy.D., L.L.C.

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1144624636
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MARTIN J. SCHOEN, PSY.D., L.L.C.
Practice address
2096 Fairways LN
Saint Paul, MN 55113-3813
Phone
(651) 503-9852
Fax
(651) 788-9554
NPI assigned
Oct 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Authorized official

Name
Dr. Martin J. Schoen, PSY.D.NPI 1225259781
Title
Licensed Psychologist/Owner
Phone
(651) 503-9852

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

2096 Fairways LN
Saint Paul, MN 55113-3813

Mailing address

PO Box 130891
Saint Paul, MN 55113-0008
Phone (651) 503-9852

Other identifiers 1

IdentifierTypeStateIssuer
680003444OtherMNMEDICARE PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141119000817 MN Part B Supplier - Clinic/Group Practice 4688896012 Receives reassigned benefits from 1 practitioner
Practice locations: Roseville, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1144624636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130891",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551130008",
            "telephone_number": "651-503-9852",
            "fax_number": "651-788-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2096 FAIRWAYS LN",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551133813",
            "telephone_number": "651-503-9852",
            "fax_number": "651-788-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN J. SCHOEN, PSY.D., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "SCHOEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "651-503-9852",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "680003444",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.