Individual provider Active NPI

Clare T Humphreys, PH.D.

  • Clinical Neuropsychologist
  • Minneapolis, MN
National Provider Identifier
1639306467
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
LP7042 Issued in MN
Practice address
701 Park Ave
Minneapolis, MN 55415-1623
Phone
(612) 873-3000
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X LP7042 MN Primary
Clinical Neuropsychologist 103G00000X 0376 NH
Clinical Neuropsychologist 103G00000X 9562 MA
Clinical Psychologist 103TC0700X 9562 MA

Addresses

Primary practice location

701 Park Ave
Minneapolis, MN 55415-1623

Mailing address

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-3000

Other identifiers 1

IdentifierTypeStateIssuer
110094861AMedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address chumphreys275135@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121129000220 MA Practitioner - Clinical Psychologist 0345492203 Reassigns benefits to 1 organization
I20240507003536 MN Practitioner - Psychiatry 0345492203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Iowa, RJ & L Carver College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LP7042MNMDClinical Neuropsychologist
9562MAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince May 30, 2015 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Jun 19, 2024 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Jun 19, 2024 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients

Locations

75 Francis St
Boston, MA 02115

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

Interoperability endpoints

  • Direct secure messaging: chumphreys275135@umassmemorial.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1639306467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151623",
            "telephone_number": "612-873-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "CLARE",
        "middle_name": "T",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MN",
            "license": "LP7042",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NH",
            "license": "0376",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "9562",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9562",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110094861A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chumphreys275135@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "100 Century Dr",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016061244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "100 Century Dr",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016061244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.