Theodore W Witte, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15341 Issued in MN

Practice address

1491 Sherburne Ave
Saint Paul, MN 55104-2416

Phone

(651) 254-4370

Fax

(651) 251-2190

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

Yes

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

Merit-based Incentive Payment System (MIPS)

Final score

85.6 of 100Reported as group

Quality

72.5

Promoting interoperability

100

Improvement activities

40

Cost

77.07

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.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Allina Health System

  • Urgent Care Clinic/Center
  • Edina, MN
  • NPI 1316553332
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD
• RHSC

  • Psychiatric Residential Treatment Facility
  • Saint Paul, MN
  • NPI 1073543344
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568686715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 SHERBURNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042416",
            "telephone_number": "651-254-4370",
            "fax_number": "651-251-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 SHERBURNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042416",
            "telephone_number": "651-254-4370",
            "fax_number": "651-251-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTE",
        "first_name": "THEODORE",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Michael Wisgerhof, LPCC
• Danielle Wissink
• Heidi Park Wiste, LICSW
• Madison Rose Witschen, MA, LPCC, LADC
• Kara Felicia Witt, PH.D
• Jessica Marie Wittenberg
• Mitchell Thomas Wittenberg, PH.D., LP
• Eric Wittkopf
• Jennifer Wittman, AU.D.
• Cassandra Wittner, CST

• 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 Jul 8, 2007; 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.