Individual provider Active NPI

Pamela Jenness Freske

  • Clinical Psychologist
  • Saint Paul, MN
National Provider Identifier
1912497041
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4592 Issued in MN
Practice address
1700 University Ave W FL 6
Saint Paul, MN 55104-3727
Phone
(651) 232-2273
NPI assigned
May 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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 4592 MN Primary

Addresses

Primary practice location

1700 University Ave W FL 6
Saint Paul, MN 55104-3727

Mailing address

3322 37TH Ave S
Minneapolis, MN 55406-2139
Phone (612) 724-5544

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
I20051208000985 MN Practitioner - Clinical Psychologist 0749201424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1700 University Ave W
6TH Floor W
Saint Paul, MN 55104-3727
Phone (651) 232-2273

Merit-based Incentive Payment System (MIPS)

Final score
92.68 of 100Reported as group
Quality
89.73
Promoting interoperability
100
Improvement activities
40
Cost
80.99

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4592MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 23, 2018 Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2021 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2021 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 23, 2018 Accepting new patients

Locations

1747 Beam Ave
Ste 100
Maplewood, MN 55109
Phone (651) 232-3900

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

1875 Woodwinds Dr
Ste 250
Woodbury, MN 55125
Phone (651) 232-0005

Organizations & group practices 6

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": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1912497041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 37TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062139",
            "telephone_number": "612-724-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W FL 6",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727",
            "telephone_number": "651-232-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESKE",
        "first_name": "PAMELA",
        "middle_name": "JENNESS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.