Active NPI
Jennifer Lynn Ostergaard, PSYD
- Psychologist
- Saint Paul, MN
National Provider Identifier
1174573778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP4698
- Practice address
- 200 University Ave E
St Paul, MN 55101-2307 - Phone
- (651) 291-2848
- NPI assigned
- May 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | MN | ||
| Psychologist | 103T00000X | LP4698 | MN | Primary |
Addresses
Primary practice location
200 University Ave E
St Paul, MN 55101-2307
Mailing address
200 University Ave E
St Paul, MN 55101-2307
Phone (651) 229-3841
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 602645000 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Great Lakes Psychology Group
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1174573778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 UNIVERSITY AVE E",
"city": "ST PAUL",
"state": "MN",
"postal_code": "551012307",
"telephone_number": "651-229-3841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 UNIVERSITY AVE E",
"city": "ST PAUL",
"state": "MN",
"postal_code": "551012307",
"telephone_number": "651-291-2848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSTERGAARD",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-12",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "MN",
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP4698",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "602645000",
"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 Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.