Individual provider Active NPI

Laura Elizabeth Accomando, PSY.D.

  • Psychologist
  • Woodbury, MN
National Provider Identifier
1790015568
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP5200 Issued in MN
Practice address
6043 Hudson Rd Ste 290
Woodbury, MN 55125-1002
Phone
(651) 268-1363
Fax
(651) 714-9029
NPI assigned
Dec 30, 2009
Last updated
Dec 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP5200 MN Primary

Addresses

Primary practice location

6043 Hudson Rd Ste 290
Woodbury, MN 55125-1002

Mailing address

6043 Hudson Rd Ste 290
Woodbury, MN 55125-1002

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
I20100225000273 MN Practitioner - Clinical Psychologist 1557405768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mental Health Systems, PCGroup PAC ID 5496710790, 18 clinicians

Practice addresses (Care Compare)

6600 France S Ave
Suite 230
Edina, MN 55435-1810
Phone (952) 835-2002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Systems PC Psychologist CurrentSince Feb 13, 2016 Accepting new patients

Locations

6600 France Ave S
Ste 230
Minneapolis, MN 55435
Phone (952) 460-9007

6043 Hudson Rd
Ste 290
Woodbury, MN 55125
Phone (651) 714-9437

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1790015568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6043 HUDSON RD STE 290",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6043 HUDSON RD STE 290",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251002",
            "telephone_number": "651-268-1363",
            "fax_number": "651-714-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACCOMANDO",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-30",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.