Individual provider Active NPI

Megan Petrik, PH.D.

  • Clinical Psychologist
  • Rochester, MN
National Provider Identifier
1932553443
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP6016 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Apr 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X LP6016 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 290-1480

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpetrik2182040@ehrdirect.mayoclinicmsg.org

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
I20160824000096 MN Practitioner - Clinical Psychologist 8628363165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP6016MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Mayo Clinic CurrentSince Jan 9, 2024 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Mayo Clinic CurrentSince Jan 9, 2024 Accepting new patients
Mayo Clinic Current Accepting new patients

Locations

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

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

420 Delaware St SE
#741
Minneapolis, MN 55455
Phone (612) 624-8984

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Interoperability endpoints

  • Direct secure messaging: mpetrik2182040@ehrdirect.mayoclinicmsg.org

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": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1932553443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 Fulton St SE",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554554800",
            "country_code": "US",
            "telephone_number": "612-290-1480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRIK",
        "first_name": "MEGAN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpetrik2182040@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "200 1st St SW",
            "city": "Rochester",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559050001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.