Organization Active NPI

Robert J Sevenich M.D.,J.D.,P.a.

Doing business as HouseCallMN

  • Psychiatry Physician
  • Maplewood, MN
National Provider Identifier
1255573358
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ROBERT J SEVENICH M.D.,J.D.,P.A.
Doing business as
HouseCallMN
Practice address
1714 Howard St N
Maplewood, MN 55109-4842
Phone
(612) 509-5522
Fax
(651) 414-0279
NPI assigned
Apr 3, 2009
Last updated
Mar 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Authorized official

Name
Rachel Polski
Title
Office Manager
Phone
(651) 444-8512

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1714 Howard St N
Maplewood, MN 55109-4842

Mailing address

855 Village Center Dr Ste 181
North Oaks, MN 55127-3016
Phone (651) 444-8512

Other identifiers 1

IdentifierTypeStateIssuer
903318100MedicaidMN

Other names 1

  • HouseCallMN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090601000202 MN Part B Supplier - Clinic/Group Practice 1254480882 Receives reassigned benefits from 1 practitioner
Practice locations: Maplewood, MN; Woodbury, MN; St Paul, MN; North Oaks, MN; Redwing, MN

National Provider Directory

National Provider Directory

Locations

988 Inwood Ave N
Oakdale, MN 55128
Phone (651) 263-4438

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1255573358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 VILLAGE CENTER DR STE 181",
            "city": "NORTH OAKS",
            "state": "MN",
            "postal_code": "551273016",
            "telephone_number": "651-444-8512",
            "fax_number": "651-414-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 HOWARD ST N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551094842",
            "telephone_number": "612-509-5522",
            "fax_number": "651-414-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J SEVENICH M.D.,J.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-03",
        "last_updated": "2021-03-29",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "POLSKI",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "651-444-8512"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "903318100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HouseCallMN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HouseCallMN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.