Individual provider Active NPI

Daniel Thomason, LP

  • Psychologist
  • Inver Grove Heights, MN
National Provider Identifier
1629093380
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP0436 Issued in MN
Practice address
5565 Blaine Ave
Inver Grove Heights, MN 55076
Phone
(651) 450-8000
Fax
(651) 450-8066
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP0436 MN Primary

Addresses

Primary practice location

5565 Blaine Ave
Inver Grove Heights, MN 55076

Mailing address

1021 Bandana Blvd E
Suite 200
Saint Paul, MN 55108-5113
Phone (651) 642-2700

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
I20050426000946 MN Practitioner - Clinical Psychologist 4183663537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eagan Counseling ClinicGroup PAC ID 2860304045, 62 clinicians

Practice addresses (Care Compare)

1000 Radio Dr
Suite 210
Woodbury, MN 55125-8444
Phone (651) 365-8209

3450 Oleary LN
Eagan, MN 55123-2340
Phone (651) 454-0114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629093380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 BANDANA BLVD E",
            "address_2": "SUITE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085113",
            "telephone_number": "651-642-2700",
            "fax_number": "651-642-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 BLAINE AVE",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "55076",
            "telephone_number": "651-450-8000",
            "fax_number": "651-450-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASON",
        "first_name": "DANIEL",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inver Grove Heights, MN

Sources for this page

Verify at the official NPI Registry.