Sumitra Dorner

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16073 Issued in MN

Practice address

2616 Nicollet Ave
Minneapolis, MN 55408-1628

Phone

(612) 871-7878

Fax

(612) 871-2567

NPI assigned

Jul 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crown Medical Support Services IncGroup PAC ID 5597050542, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Crown Medical Support Services Inc

  • Community Health Clinic/Center
  • Minneapolis, MN
  • NPI 1730546672
  Medicare reassignment Care Compare group
• Recovery Alliance LLC

  • Community/Behavioral Health Agency
  • Minneapolis, MN
  • NPI 1285258111
  Medicare reassignment NPD
• Twin Cities Recovery Center LLC

  • Community/Behavioral Health Agency
  • Eden Prairie, MN
  • NPI 1376162941
  Medicare reassignment NPD
• Addiction Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn Park, MN
  • NPI 1932452885
  NPD (past)

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1962692798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081628",
            "telephone_number": "612-871-7878",
            "fax_number": "612-871-2567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081628",
            "telephone_number": "612-871-7878",
            "fax_number": "612-871-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNER",
        "first_name": "SUMITRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Doran, CNP
• Kunsang Dorjee, RN
• Courtney Marie Dorle, PA-C
• Michelle Lynn Dornan-Vickery
• Brianna Elizabeth Dornan
• Bradleigh J Dornfeld, MD
• Cheryl Dornfeld, LPCC
• Lisa Berntson Dornick, PNP
• John Z Doroschak, DDS
• Michael Dennis Doroschak, DDS

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.