Individual provider Active NPI

Theresa Magelky, PH.D

  • Psychologist
  • Minot, ND
National Provider Identifier
1508224254
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
525 Issued in ND
Practice address
1900 8TH Ave SE
Minot, ND 58701-4935
Phone
(701) 857-5998
NPI assigned
Feb 9, 2016
Last updated
Jul 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 525 ND Primary

Addresses

Primary practice location

1900 8TH Ave SE
Minot, ND 58701-4935

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 857-5118

Other practice location 1

1237 W Divide Ave Ste 5
Bismarck, ND 58501-1208
Phone (701) 328-8888

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
I20160310000975 ND Practitioner - Clinical Psychologist 8628374089 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solutions Behavioral Healthcare Professionals PCGroup PAC ID 0345209524, 30 clinicians

Practice addresses (Care Compare)

4503 Coleman St
Suite 203
Bismarck, ND 58503-2017
Phone (701) 412-2973

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
525NDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions Behavioral Healthcare Professionals, PC Psychologist CurrentSince Jul 31, 2024 Accepting new patients
North Dakota State Hospital CurrentSince Mar 1, 2017 Accepting new patients
Dakota Institute of Trauma Therapy, PC CurrentSince Oct 3, 2016 Accepting new patients

Locations

1547 30th Ave S
Moorhead, MN 56560
Phone 21828743381113

1002 E Central Ave
Bismarck, ND 58501
Phone (701) 751-4447

600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644

4503 Coleman St
Ste 203
Bismarck, ND 58503
Phone (701) 412-2973

2605 Circle Dr
Jamestown, ND 58401
Phone (701) 253-3650

Organizations & group practices 3

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": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1508224254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-857-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 8TH AVE SE",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014935",
            "telephone_number": "701-857-5998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1237 W Divide Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585011208",
            "country_code": "US",
            "telephone_number": "701-328-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGELKY",
        "first_name": "THERESA",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.