Individual provider Active NPI

Lisa Rogers, L.P.

  • Clinical Psychologist
  • Saint Paul, MN
National Provider Identifier
1285706507
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3260 Issued in MN
Practice address
790 Cleveland Ave S Ste 201
Saint Paul, MN 55116-3845
Phone
(612) 808-9730
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP3260 MN
Clinical Psychologist 103TC0700X 3260 MN Primary

Addresses

Primary practice location

790 Cleveland Ave S Ste 201
Saint Paul, MN 55116-3845

Mailing address

790 Cleveland Ave S
Ste 201
Saint Paul, MN 55116-3845
Phone (651) 645-5323

Other practice location 1

2550 University Ave W
Suite 314N
Saint Paul, MN 55114-1052
Phone (651) 645-5323 ext. 301

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050425000974 MN Practitioner - Clinical Psychologist 4880633387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

790 Cleveland Ave S
Suite 201
Saint Paul, MN 55116-3845
Phone (612) 808-9730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Great River Psychotherapy PLLC Clinical CurrentSince Oct 16, 2019 Accepting new patients

Locations

790 Cleveland Ave S
Ste 201
Saint Paul, MN 55116
Phone (612) 808-9730

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1285706507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 CLEVELAND AVE S",
            "address_2": "STE 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551163845",
            "telephone_number": "651-645-5323",
            "fax_number": "651-647-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CLEVELAND AVE S STE 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551163845",
            "telephone_number": "612-808-9730"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 University Ave W",
            "address_2": "Suite 314N",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141052",
            "country_code": "US",
            "telephone_number": "651-645-5323 x301",
            "fax_number": "651-647-5135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "LISA",
        "credential": "L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP3260",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "3260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.