Individual provider Active NPI

Georgia E Panopoulos, PHD, LP

  • Psychologist
  • Edina, MN
National Provider Identifier
1578537692
Registry record updated Sep 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP4025 Issued in MN
Practice address
7201 Metro Blvd Ste 550
Edina, MN 55439-1353
Phone
(612) 360-5108
Fax
(952) 487-0483
NPI assigned
Feb 15, 2006
Last updated
Sep 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP4025 MN Primary

Addresses

Primary practice location

7201 Metro Blvd Ste 550
Edina, MN 55439-1353

Mailing address

130 Sunrise CT
Medina, MN 55340-4554
Phone (612) 360-5108

Other practice location 1

2621 Greenhaven Rd
Anoka, MN 55303-5566
Phone (763) 587-4488

Other identifiers 1

IdentifierTypeStateIssuer
571513000MedicaidMN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050221000452 MN Practitioner - Clinical Psychologist 4183676968 Reassigns benefits to 1 organization
Practice locations: Edina, MN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
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)

2621 Greenhaven Rd
Anoka, MN 55303-1776
Phone (952) 853-8800

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP4025MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Jul 27, 2015 Accepting new patients
Minnesota Head and Neck Pain Clinic, PA Past Accepting new patients

Locations

2621 Greenhaven Rd
Anoka, MN 55303
Phone (763) 587-4400

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

Interoperability endpoints

  • Direct secure messaging: gpanopoulos132949@direct.healthpartners.com

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1578537692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUNRISE CT",
            "city": "MEDINA",
            "state": "MN",
            "postal_code": "553404554",
            "telephone_number": "612-360-5108",
            "fax_number": "952-487-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 METRO BLVD STE 550",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391353",
            "telephone_number": "612-360-5108",
            "fax_number": "952-487-0483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2621 Greenhaven Rd",
            "address_purpose": "LOCATION",
            "city": "Anoka",
            "state": "MN",
            "postal_code": "553035566",
            "country_code": "US",
            "telephone_number": "763-587-4488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANOPOULOS",
        "first_name": "GEORGIA",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "571513000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.