Mikki Jo Rothbauer, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15399 Issued in MN

Practice address

640 Jackson St
Burn Center C5400
Saint Paul, MN 55101-2502

Phone

(651) 254-2030

Fax

(651) 254-6870

NPI assigned

Jun 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

University of Minnesota Medical School, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Regions Hospital Hospital, Saint Paul, MN, CCN 240106

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Pediatric Dentistry
  • Minneapolis, MN
  • NPI 1700932449
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regions Hospital

  • Pharmacy
  • Saint Paul, MN
  • NPI 1013951748

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1104681105
  Care Compare affiliation
• Regions Hospital

  • Rehabilitation Clinic/Center
  • Saint Paul, MN
  • NPI 1134157092

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1306873872
  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Saint Paul, MN
  • NPI 1629006457
  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Stillwater, MN
  • NPI 1679391122
  Care Compare affiliation
• Regions Hospital

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1871929976

  Hospital

  Care Compare affiliation
• Regions Hospital

  • General Acute Care Hospital
  • Coon Rapids, MN
  • NPI 1962149419
  Care Compare affiliation

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

{
    "created_epoch": "1435104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435104000000",
    "number": "1548642770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "address_2": "BURN CENTER C5400",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-2030",
            "fax_number": "651-254-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "address_2": "BURN CENTER C5400",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-2030",
            "fax_number": "651-254-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBAUER",
        "first_name": "MIKKI",
        "middle_name": "JO",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-24",
        "last_updated": "2015-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca C Rossom, M.D.
• Lauryn Roszak, PT
• Matthew J Roszkowski, DDS MS
• Dan Rotach, D,MIN., LMFT
• Anna Laurie Roth, M.A. LMHC
• Willow Rothenberg
• Rotibola LLC
• John F Rotilie, MD
• Rotilie, Toman, McRaith, LLC
• Peter Rotondo

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; 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.

Verify at the official NPI Registry.