Individual provider Active NPI

Kristine M Meyer-Rubado, MA, LP

  • Counseling Psychologist
  • Rochester, MN
National Provider Identifier
1487781514
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP3442 Issued in MN
Practice address
975 34TH Ave NW
Suite 215
Rochester, MN 55901
Phone
(507) 288-5818
Fax
(507) 424-1052
NPI assigned
Feb 27, 2007
Last updated
Jun 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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 LP3442 MN
Counseling Psychologist 103TC1900X LP3442 MN Primary

Addresses

Primary practice location

975 34TH Ave NW
Suite 215
Rochester, MN 55901

Mailing address

975 34TH Ave NW
Suite 215
Rochester, MN 55901
Phone (507) 288-5818

Other identifiers 5

IdentifierTypeStateIssuer
158223200MedicaidMN
140013OtherMNUCARE
921001022822OtherMNPREFERRED ONE
HP29916OtherMNHEALTHPARTNERS
39P82MEOtherMNBCBS OF MN

Other names 1

  • Kristine M Meyer Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP3442MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheila M. Daley, PLC PastSince May 14, 2023 Accepting new patients
Associates in Psychiatry and Psychology Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1487781514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 34TH AVE NW",
            "address_2": "SUITE 215",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55901",
            "telephone_number": "507-288-5818",
            "fax_number": "507-424-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 34TH AVE NW",
            "address_2": "SUITE 215",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55901",
            "telephone_number": "507-288-5818",
            "fax_number": "507-424-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER-RUBADO",
        "first_name": "KRISTINE",
        "middle_name": "M",
        "credential": "MA, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP3442",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP3442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158223200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "140013",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "921001022822",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP29916",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "39P82ME",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "MEYER",
            "middle_name": "M",
            "credential": "MA, LP, PLLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.