Individual provider Active NPI

Kelsey Marie Hyde, PSYD

  • Clinical Psychologist
  • Chaska, MN
National Provider Identifier
1962804773
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6664 Issued in MN
Practice address
1435 White Oak Dr Ste 200
Chaska, MN 55318-2567
Phone
(952) 443-4600
NPI assigned
Sep 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY.0005351 CO
Clinical Psychologist 103TC0700X 6664 MN Primary

Addresses

Primary practice location

1435 White Oak Dr Ste 200
Chaska, MN 55318-2567

Mailing address

PO Box 51
Victoria, MN 55386-0051

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
I20210407000498 MN Practitioner - Clinical Psychologist 3779990874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jessica Dresden PSYD LP LLCGroup PAC ID 0042642449, 4 clinicians

Practice addresses (Care Compare)

760 Stillwater Rd
Suite 101
Mahtomedi, MN 55115-2060
Phone (651) 760-0866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY.0005351COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jessica Dresden PSYD LP LLC CurrentSince Dec 21, 2024 Accepting new patients
Elevated Insights Assessment Clinical PastSince Oct 1, 2020 Accepting new patients

Locations

760 Stillwater Rd
Ste 101
Saint Paul, MN 55115
Phone (651) 760-0866

Organizations & group practices 2

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1962804773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51",
            "city": "VICTORIA",
            "state": "MN",
            "postal_code": "553860051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 WHITE OAK DR STE 200",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182567",
            "telephone_number": "952-443-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDE",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0005351",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "6664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chaska, MN

Sources for this page

Verify at the official NPI Registry.