Individual provider Active NPI

Luke Abraham Tervola

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1609405240
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20767 Issued in MN
Practice address
221 W 4TH St Ste 300
Duluth, MN 55806-2719
Phone
(218) 640-1027
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 20767 MN Primary

Addresses

Primary practice location

221 W 4TH St Ste 300
Duluth, MN 55806-2719

Mailing address

221 W 4TH St Ste 300
Duluth, MN 55806-2719
Phone (218) 640-1027

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
I20230126000446 MN Practitioner - Clinical Social Worker 2961873138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
78.26 of 100Reported as group
Quality
80.41
Promoting interoperability
80
Improvement activities
40
Cost
53.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20767MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fond Du Lac Reservation Business Committee CurrentSince Jan 15, 2023 Accepting new patients
Fond Du Lac Reservation Business Committee Current Accepting new patients

Locations

927 Trettel Ln
Cloquet, MN 55720
Phone (218) 879-1227

221 W 4th St
Ste 300
Duluth, MN 55806
Phone (218) 640-1027

211 W 4th St
Duluth, MN 55806
Phone (218) 726-1370

Interoperability endpoints

  • Direct secure messaging: luke.tervola.p1@direct.fonddulachsd.nextgenshare.com

Organizations & group practices 2

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1609405240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W 4TH ST STE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558062719",
            "telephone_number": "218-640-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W 4TH ST STE 300",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558062719",
            "telephone_number": "218-640-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERVOLA",
        "first_name": "LUKE",
        "middle_name": "ABRAHAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.