Individual provider Active NPI

Pamela Gale Schiele, PSYD, LP

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1790832764
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4722 Issued in MN
Practice address
4530 W 77TH St Ste 200
Minneapolis, MN 55435-5013
Phone
(952) 832-5244
Fax
(952) 832-5297
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP4722 MN Primary

Addresses

Primary practice location

4530 W 77TH St Ste 200
Minneapolis, MN 55435-5013

Mailing address

4530 W 77TH St Ste 200
Minneapolis, MN 55435-5013
Phone (952) 832-5244

Other identifiers 1

IdentifierTypeStateIssuer
HP71705OtherMNHEALTH PARTNERS

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
I20210124000009 MN Practitioner - Clinical Psychologist 0547674020 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP4722MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Scott CurrentSince Oct 9, 2020 Accepting new patients
County of Scott CurrentSince Oct 9, 2020 Accepting new patients
County of Scott Past Accepting new patients

Locations

200 4th Ave W
Shakopee, MN 55379
Phone (952) 496-8481

200 4th Ave W
Ste 300
Shakopee, MN 55379
Phone (952) 496-8481

Organizations & group practices 3

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790832764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 W 77TH ST STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554355013",
            "telephone_number": "952-832-5244",
            "fax_number": "952-832-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 W 77TH ST STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554355013",
            "telephone_number": "952-832-5244",
            "fax_number": "952-832-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIELE",
        "first_name": "PAMELA",
        "middle_name": "GALE",
        "name_prefix": "Dr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP71705",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.