Individual provider Active NPI

Gerald Schwanke, LMFT

  • Marriage & Family Therapist
  • Chaska, MN
National Provider Identifier
1922436716
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2082 Issued in MN
Practice address
111 Hundertmark Rd Ste 205N
Chaska, MN 55318-1586
Phone
(952) 903-1350
NPI assigned
Oct 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2082 MN Primary

Addresses

Primary practice location

111 Hundertmark Rd Ste 205N
Chaska, MN 55318-1586

Mailing address

Prairiecare
9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (763) 762-8800

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Chaska Health Information Exchange (HIE)

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
I20240227002494 MN Practitioner - Marriage and Family Therapist 4284079542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Croix Psychiatric LLCGroup PAC ID 9335288786, 45 clinicians

Practice addresses (Care Compare)

9400 Zane Ave N
Brooklyn Park, MN 55443-1814
Phone (952) 826-8475

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2082MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Croix Psychiatric, LLC Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

111 Hundertmark Rd
Ste 205N
Chaska, MN 55318
Phone (952) 903-1350

12915 63rd Ave N
Maple Grove, MN 55369
Phone (763) 383-5800

9400 Zane Ave N
Minneapolis, MN 55443
Phone (763) 383-5800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1922436716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PRAIRIECARE",
            "address_2": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HUNDERTMARK RD STE 205N",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553181586",
            "telephone_number": "952-903-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWANKE",
        "first_name": "GERALD",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-15",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chaska",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "111 Hundertmark Rd Ste 205N",
            "city": "Chaska",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553181586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chaska, MN

Sources for this page

Verify at the official NPI Registry.