Individual provider Active NPI

Ryan Sorensen, PSY.D., L.P.

  • Psychologist
  • Fridley, MN
National Provider Identifier
1669711495
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP5584 Issued in MN
Practice address
520 Osborne Rd NE Ste 210
Fridley, MN 55432-2718
Phone
(763) 236-3800
Fax
(763) 236-3821
NPI assigned
Feb 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP 5584 MN
Psychologist 103T00000X LP5584 MN Primary

Addresses

Primary practice location

520 Osborne Rd NE Ste 210
Fridley, MN 55432-2718

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rsorensen670788@excellian.direct.allina.com Direct

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
I20130425000550 MN Practitioner - Clinical Psychologist 4082850797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

520 Osborne Rd NE
Suite 210
Fridley, MN 55432-2718
Phone (763) 236-3800

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP 5584MNMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Sep 16, 2024 Accepting new patients
Allina Health System CurrentSince Sep 16, 2024 Accepting new patients
Emily Program P C CurrentSince Feb 4, 2013 Accepting new patients
Allina Health System Current Accepting new patients

Locations

520 Osborne Rd NE
Ste 210
Fridley, MN 55432
Phone (763) 236-3800

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2265 Como Ave
Saint Paul, MN 55108

Interoperability endpoints

  • Direct secure messaging: rsorensen670788@excellian.direct.allina.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.

NPI Registry JSON

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1669711495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 OSBORNE RD NE STE 210",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322718",
            "telephone_number": "763-236-3800",
            "fax_number": "763-236-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D., L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-14",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP 5584",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rsorensen670788@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "520 Osborne Rd NE Ste 210",
            "city": "Fridley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554322718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.