Individual provider Active NPI

Jill Marthaler, DMFT, LMFT

  • Marriage & Family Therapist
  • St Louis Park, MN
National Provider Identifier
1619340908
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2293 Issued in MN
Practice address
1665 Utica Ave S Ste 100
Saint Louis Park, MN 55416-3476
Phone
(952) 541-2500
Fax
(952) 541-2539
NPI assigned
Nov 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2293 MN Primary

Addresses

Primary practice location

1665 Utica Ave S Ste 100
Saint Louis Park, MN 55416-3476

Mailing address

8170 33Rd Ave S
Ms 21110Q
Bloomington, MN 55425-4516

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
I20240102003823 MN Practitioner - Marriage and Family Therapist 8426408428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
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)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2293MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

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

1665 Utica Ave S
Ste 100
St Louis Park, MN 55416
Phone (952) 541-2500

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": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1619340908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 UTICA AVE S STE 100",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554163476",
            "telephone_number": "952-541-2500",
            "fax_number": "952-541-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTHALER",
        "first_name": "JILL",
        "credential": "DMFT, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-09",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.