NPIMap

Individual provider Active NPI

Heather Lanae Bajema, PSY.D.

  • Clinical Psychologist
  • Worthington, MN
National Provider Identifier
1922276195
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4893 Issued in MN
Practice address
1024 7TH Ave
Worthington, MN 56187-2287
Phone
(507) 376-4141
Fax
(507) 376-4494
NPI assigned
Feb 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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 LP4893 MN Primary

Addresses

Primary practice location

1024 7TH Ave
Worthington, MN 56187-2287

Mailing address

216 E Luverne St
PO Box 686
Luverne, MN 56156-1610
Phone (507) 283-9511

Other identifiers 1

IdentifierTypeStateIssuer
360608000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080404000554 MN Practitioner - Clinical Psychologist 9739266438 Reassigns benefits to 1 organization
I20211117001974 SD Practitioner - Clinical Psychologist 9739266438

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Sioux Falls, SD 57118-6370

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP4893MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Nov 1, 2021 Accepting new patients
Southwestern Mental Health Center Inc CurrentSince Jan 25, 2008 Accepting new patients
Avera McKennan CurrentSince Nov 1, 2021 Accepting new patients
Avera McKennan Current Accepting new patients

Locations

216 E Luverne St
Luverne, MN 56156
Phone (507) 283-9511

117 S Spring St
Luverne, MN 56156
Phone (507) 283-9511

1024 7th Ave
Worthington, MN 56187
Phone (507) 376-4141

4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700

Interoperability endpoints

  • Direct secure messaging: heather.bajema@avera.sdhealthlink.net

Organizations & group practices 4

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.

  • Southwestern Mental Health Center Inc
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Luverne, MN
    • NPI 1487654562
    Medicare reassignment NPD
  • Avera McKennan

    dba Avera Medical Group University Psychiatry Associates Sioux Falls

    • Psychiatry Physician
    • Sioux Falls, SD
    • NPI 1013980598
    NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678
    NPD
  • Avera McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944
    NPD

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1922276195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 E LUVERNE ST",
            "address_2": "PO BOX 686",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561561610",
            "telephone_number": "507-283-9511",
            "fax_number": "507-283-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 7TH AVE",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561872287",
            "telephone_number": "507-376-4141",
            "fax_number": "507-376-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJEMA",
        "first_name": "HEATHER",
        "middle_name": "LANAE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360608000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, MN

Sources for this page

Verify at the official NPI Registry.