Individual provider Active NPI

Peter A Schmutzer, PHD

  • Clinical Psychologist
  • Grand Forks, ND
National Provider Identifier
1477623866
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
476 Issued in ND
Practice address
3535 S 31St St Ste 201
Grand Forks, ND 58201-3593
Phone
(701) 780-6821
Fax
(701) 780-1973
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 476 ND Primary

Addresses

Primary practice location

3535 S 31St St Ste 201
Grand Forks, ND 58201-3593

Mailing address

3535 S 31St St Ste 201
Grand Forks, ND 58201-3593
Phone (701) 780-6821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20130213000137 ND Practitioner - Clinical Psychologist 6901050301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of North Dakota School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Assessment and Therapy Associates of Grand Forks PLLCGroup PAC ID 9436152626, 17 clinicians

Practice addresses (Care Compare)

3535 S 31St St
Suite 201
Grand Forks, ND 58201-3593
Phone (701) 780-6821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
476NDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Assessment and Therapy Associates of Grand Forks, PLLC Clinical CurrentSince Oct 16, 2012 Accepting new patients

Locations

3535 S 31st St
Ste 201
Grand Forks, ND 58201
Phone (701) 780-6821

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1477623866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 S 31ST ST STE 201",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013593",
            "telephone_number": "701-780-6821",
            "fax_number": "701-780-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 S 31ST ST STE 201",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013593",
            "telephone_number": "701-780-6821",
            "fax_number": "701-780-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMUTZER",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

Verify at the official NPI Registry.