Jeremy William Rondorf, PSY.D.

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

Practice address

15245 Pleasant Valley Rd
Center City, MN 55012-9640

Phone

(651) 213-4184

Fax

(651) 213-4411

NPI assigned

Jan 8, 2007

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

Electronic endpoints 1

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.6 of 100Reported as group

Quality

72.5

Promoting interoperability

100

Improvement activities

40

Cost

77.07

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrondorf290308@excellian.direct.allina.com

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.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Allina Health System

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD
• Allina Health System

  • Family Medicine Physician
  • Faribault, MN
  • NPI 1013213826
  NPD
• Allina Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Owatonna, MN
  • NPI 1619911179
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1639227135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15245 PLEASANT VALLEY RD",
            "city": "CENTER CITY",
            "state": "MN",
            "postal_code": "550129640",
            "telephone_number": "651-213-4184",
            "fax_number": "651-213-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15245 PLEASANT VALLEY RD",
            "city": "CENTER CITY",
            "state": "MN",
            "postal_code": "550129640",
            "telephone_number": "651-213-4184",
            "fax_number": "651-213-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONDORF",
        "first_name": "JEREMY",
        "middle_name": "WILLIAM",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrondorf290308@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1540 Lake St S",
            "city": "Forest Lake",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550252628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dorine Rosella Reiter, PSY.D., LP
• Angela Rempelewert, MA LPC
• Alemu Kassa Reta
• Jorge Efrain Rey de Oliveira
• Jeffrey Earl Rivard, D.D.S.
• Kabita Roy, PSYD RN
• Bishoy T Samuel, MD
• Ann Schissel
• Julia Schott
• Kent David Smallwood, PH.D.

• Addiction (Substance Use Disorder) Psychologist in Center City, MN
• Providers in Center City, MN by specialty
• Addiction (Substance Use Disorder) Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.