Individual provider Active NPI

Abbey Kanzer, PSY.D.

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1861544132
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4737 Issued in MN
Practice address
717 E River Pkwy
Minneapolis, MN 55455-0369
Phone
(612) 436-4832
Fax
(612) 436-2604
NPI assigned
Jan 17, 2007
Last updated
Mar 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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 LP4737 MN Primary

Addresses

Primary practice location

717 E River Pkwy
Minneapolis, MN 55455-0369

Mailing address

575 Stinson Blvd
#C-12
New Brighton, MN 55112-2563
Phone (651) 247-1941

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
I20080410000756 MN Practitioner - Clinical Psychologist 3375620669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

8550 Hudson Blvd N
Lake Elmo, MN 55042-5500
Phone (651) 254-8580

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP4737MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince May 22, 2019 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince May 22, 2019 Accepting new patients
Center for Victims of Torture Past Accepting new patients
Center for Victims of Torture - Bethesda Past Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

Organizations & group practices 5

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1861544132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 STINSON BLVD",
            "address_2": "#C-12",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122563",
            "telephone_number": "651-247-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 E RIVER PKWY",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550369",
            "telephone_number": "612-436-4832",
            "fax_number": "612-436-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANZER",
        "first_name": "ABBEY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.