Individual provider Active NPI

Jonathan C. Hoistad, PH.D.

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1588779292
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP1788 Issued in MN
Practice address
1821 University Ave W Ste 155
Saint Paul, MN 55104-2880
Phone
(612) 800-6500
Fax
(612) 800-6501
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1535-057 WI
Psychologist 103T00000X 716 MN
Psychologist 103T00000X LP1788 MN Primary

Addresses

Primary practice location

1821 University Ave W Ste 155
Saint Paul, MN 55104-2880

Mailing address

1821 University Ave W Ste 155
Saint Paul, MN 55104-2880
Phone (612) 800-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050908000663 MN Practitioner - Clinical Psychologist 2961433982 Reassigns benefits to 1 organization
I20051010000138 WI Practitioner - Clinical Psychologist 2961433982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Natalis Outcomes, LLCGroup PAC ID 1557790144, 2 clinicians

Practice addresses (Care Compare)

1821 University Ave W
Suite 155
Saint Paul, MN 55104-2880
Phone (612) 800-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
716MNMDPsychologist
LP1788MNMDPsychologist
1535-057WIMDPsychologist
1535WIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Natalis Outcomes, LLC CurrentSince Feb 9, 2020 Accepting new patients
St Croix County CurrentSince Sep 26, 2006 Accepting new patients
St Croix County CurrentSince Sep 26, 2006 Accepting new patients
West Central Counseling LLC PastSince Jun 6, 2021 Accepting new patients

Locations

1821 University Ave W
Ste 155
Saint Paul, MN 55104
Phone (612) 800-6500

855 Village Center Dr
Saint Paul, MN 55127
Phone (651) 232-1978

1445 N 4th St
New Richmond, WI 54017
Phone (715) 246-6991

1752 Dorset Ln
New Richmond, WI 54017
Phone (715) 246-6991

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1588779292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE 155",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042880",
            "telephone_number": "612-800-6500",
            "fax_number": "612-800-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 UNIVERSITY AVE W STE 155",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042880",
            "telephone_number": "612-800-6500",
            "fax_number": "612-800-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOISTAD",
        "first_name": "JONATHAN",
        "middle_name": "C.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1535-057",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "716",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.