Leigh-Ann Theophilos, PSY D

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

900 Long Lake Rd Ste 160
New Brighton, MN 55112-6414

Phone

(612) 706-9630

NPI assigned

Sep 15, 2021

Sex

Female

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

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Care Services, PAGroup PAC ID 5890865463, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Medical Care Services, PA

  • Family Medicine Physician
  • New Brighton, MN
  • NPI 1083778708
  Medicare reassignment Care Compare group NPD
• Health and Wellness Collaborative

  • Clinical Psychologist
  • New Brighton, MN
  • NPI 1548822943
  NPD

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

{
    "created_epoch": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1780354464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 160",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126414",
            "telephone_number": "612-706-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LONG LAKE RD STE 160",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126414",
            "telephone_number": "612-706-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEOPHILOS",
        "first_name": "LEIGH-ANN",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Tessmer
• Brian Michael Teuber, LADC
• Tina S. Thakrar, M.D.
• The Woodland Center for Psychotherapy
• Julie Ann Theisen, LADC
• Theresa M. Snell
• Anna Thier
• Lisa Michelle Thistle, LMFT
• Duane Hugh Thompson, MA, LP
• Miranda Jean Thurmer, M.A.

• Psychologist in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.