Kara A Derner, PSY.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5337 Issued in MN

Practice address

1407 S State St
New Ulm, MN 56073-3715

Phone

(507) 354-3181

NPI assigned

Nov 29, 2007

Last updated

Jul 11, 2011By the provider in NPPES

Sex

Female

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 1

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Eden Therapy Center, LLCGroup PAC ID 7810381985, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eden Therapy Center, LLC

  dba Eden Therapy Center

  • Mental Health Counselor
  • Eden Prairie, MN
  • NPI 1275037277
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1275715492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 S STATE ST",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "560733715",
            "telephone_number": "507-354-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 S STATE ST",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "560733715",
            "telephone_number": "507-354-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERNER",
        "first_name": "KARA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D., L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "386981400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Dallenbach, REGISTERED NURSE
• Christopher Brys Davis, MSN LICSW
• Kelsey Leigh Deeter, DO
• Lance Deeter, DO
• Dental Health Clinic P.a.
• Mario L Desouza, MD
• Steven Scott Dew
• Randeep Singh Dhami, M.D.
• Andrew Dickinson, M.D.
• Diocese of New Ulm (Diocese of New Ulm - Catholic Charities)

• Clinical Psychologist in New Ulm, MN
• Providers in New Ulm, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.