Joseph Shagalow, PSYD LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP4413 Issued in MN

Practice address

7200 France Ave
Ste 327
Edina, MN 55435-4310

Phone

(952) 835-2002

Fax

(952) 835-9889

NPI assigned

Sep 20, 2006

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

Other identifiers 4

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, 2001

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Twin Cities Behavioral Health, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Edina, MN
  • NPI 1295979664
  Medicare reassignment NPD Authorized official
• Twin Cities Behavioral Health PC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Buffalo, MN
  • NPI 1013311802
  NPD (past) Authorized official
• Twin Cities Behavioral Health, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Buffalo, MN
  • NPI 1659674489
  NPD (past) Authorized official
• Mental Health Systems PC

  • Psychologist
  • Edina, MN
  • NPI 1497835656
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164520284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 FRANCE AVE",
            "address_2": "STE 327",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354310",
            "telephone_number": "952-835-2002",
            "fax_number": "952-835-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 FRANCE AVE",
            "address_2": "STE 327",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354310",
            "telephone_number": "952-835-2002",
            "fax_number": "952-835-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAGALOW",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PSYD LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6192891",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "150R5BH",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "171138",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP39213",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seven Realms Solutions
• Eran Severson
• Mariah C Sexe, PA-C
• Jeffrey Daniel Seybold, M.D.
• Julie Kathleen Shaffrey, M.D.
• Rajiv Ramanik Shah, M.D.
• Rina V Shah, PA-C
• Joseph Shama
• Michelle Perry Shamash, OTRL CHT
• Leah Nan Shanks, MS, LPCC, NCC, LSC

• Psychologist in Edina, MN
• Providers in Edina, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.