Craig Martin Roelke, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5636 Issued in MN

Practice address

6063 Hudson Rd
Suite 200
Woodbury, MN 55125-4454

Phone

(952) 460-9022

Fax

(651) 714-9029

NPI assigned

Jul 15, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Associated Clinic of Psychology IncGroup PAC ID 0749171320, 136 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292

  WI

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373846400000",
    "number": "1750722195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 CONCORDIA AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045418",
            "telephone_number": "612-810-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6063 HUDSON RD",
            "address_2": "SUITE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254454",
            "telephone_number": "952-460-9022",
            "fax_number": "651-714-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROELKE",
        "first_name": "CRAIG",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Lynn Rodriguez Benke
• Amy Marie Leighia Rodriguez
• Maria Paula Rodriguez, AUD, CCC-A
• Nidia Maylen Rodriguez
• Sarah Roehrich, RN
• Shanna L Roesler McElwain, OTR/L
• Michelle Maria Rofkahr
• Dajonai Rohlf
• Darrell Jerome Rohling II, MA, LP, LICSW
• Ryan W Roiger, PA-C

• Clinical Psychologist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2013; 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.