Jon Colombo

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP 5165 Issued in MN

Practice address

8669 Eagle Point Blvd
Lake Elmo, MN 55042-8628

Phone

(651) 379-0444

NPI assigned

Oct 20, 2005

Sex

Male

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 Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bachmann and Associates IncGroup PAC ID 0749271781, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Bachmann and Associates, Inc. Dba Counseling Care

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Elmo, MN
  • NPI 1538158506
  Medicare reassignment Care Compare group NPD
• Bachmann and Associates, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Lake Elmo, MN
  • NPI 1144210899
  NPD

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323907200000",
    "number": "1609865674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8669 EAGLE POINT BLVD",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428628",
            "telephone_number": "651-379-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8669 EAGLE POINT BLVD",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550428628",
            "telephone_number": "651-379-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOMBO",
        "first_name": "JON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP 5165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Nicole Brown, MA, LPCC
• Emily Clara Jindra Cable, DPT
• Bruce Douglas Campbell, DDS
• Amee Natvar Chandrabalan, D.O.
• Hope Chang
• Jennifer Conrad, LICSW
• Patrick C Corrigan, PA-C
• Frances Culbertson, D.C..
• Michelle Cunningham
• Ana Flavia Da Rocha Pereira, LMT

• Clinical Psychologist in Lake Elmo, MN
• Providers in Lake Elmo, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; 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.