Active NPI
David John Baraga, PH D LP
- Psychologist
- Saint Cloud, MN
National Provider Identifier
1679519789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP0452
- Practice address
- 1321 13TH St N
Saint Cloud, MN 56303-2613 - Phone
- (320) 252-5010
- Fax
- (320) 203-1855
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP0452 | MN | Primary |
Addresses
Primary practice location
1321 13TH St N
Saint Cloud, MN 56303-2613
Mailing address
1321 13TH St N
Saint Cloud, MN 56303-2613
Phone (320) 252-5010
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54059BA | Other | BCBS | |
| HP25561 | Other | HEALTH PARTNERS | |
| 110583C851 | Other | UCARE | |
| 6120067 | Other | MEDICA | |
| 922241022553 | Other | PREFERRED ONE | |
| 16933 | Other | OPTUM | |
| 345547500 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP0452 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264550400000",
"number": "1679519789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 13TH ST N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032613",
"telephone_number": "320-252-5010",
"fax_number": "320-203-1855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 13TH ST N",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032613",
"telephone_number": "320-252-5010",
"fax_number": "320-203-1855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARAGA",
"first_name": "DAVID",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "PH D LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2010-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP0452",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "54059BA",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP25561",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "110583C851",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6120067",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "922241022553",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUM",
"identifier": "16933",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "345547500",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.