Active NPI
Jill Raven Leer, PHD, LP
- Psychologist
- St Louis Park, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP5283
- Practice address
- 3525 Monterey Drive
Park Nicollet Clinic Melrose Institute
St Louis Park, MN 55416 - Phone
- (952) 993-6200
- NPI assigned
- Sep 13, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP5283 | MN | Primary |
Addresses
Primary practice location
3525 Monterey Drive
Park Nicollet Clinic Melrose Institute
St Louis Park, MN 55416
Mailing address
3525 Monterey Dr
Park Nicollet Clinic Melrose Institute
St Louis Park, MN 55416
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3525 Monterey Dr
St Louis Park, MN 55416-5275
Phone (952) 993-1990
5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400
6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone (952) 993-3123
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP5283 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients | |
| Park Nicollet Clinic | Current | Accepting new patients |
Locations
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
3525 Monterey Dr
St Louis Park, MN 55416
Phone (952) 993-1990
Organizations & group practices 2
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.
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maple Grove, MN
- NPI 1174980692
-
dba Park Nicollet Methodist Hospital Outpatient Surgery Center
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1194113217
-
dba PN Methodist Hospital Episodic Bundle
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1245615772
-
dba Park Nicollet Melrose Center
- Mental Illness Community Based Residential Treatment Facility
- St Louis Park, MN
- NPI 1578717336
Hospital
-
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1649220724
-
dba Park Nicollet Melrose Center
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1942585286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1396052338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3525 MONTEREY DR",
"address_2": "PARK NICOLLET CLINIC MELROSE INSTITUTE",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3525 MONTEREY DRIVE",
"address_2": "PARK NICOLLET CLINIC MELROSE INSTITUTE",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55416",
"telephone_number": "952-993-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEER",
"first_name": "JILL",
"middle_name": "RAVEN",
"name_prefix": "Dr.",
"credential": "PHD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-13",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP5283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.