Diana M Poch, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6260 Issued in MN

Practice address

3235 220TH St E
Hampton, MN 55031-9636

Phone

(192) 086-0015

NPI assigned

Jun 13, 2022

Last updated

Jun 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Washoe Tribe of Nevada and CaliforniaGroup PAC ID 8527971662, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: diana.pochphd.p1@direct.wthc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Washoe Tribe of Nevada and California

  dba Washoe Tribal Health Clinic

  • Clinic/Center
  • Gardnerville, NV
  • NPI 1396778379

  TX

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1972233047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 220TH ST E",
            "city": "HAMPTON",
            "state": "MN",
            "postal_code": "550319636",
            "telephone_number": "192-086-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 220TH ST E",
            "city": "HAMPTON",
            "state": "MN",
            "postal_code": "550319636",
            "telephone_number": "192-086-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCH",
        "first_name": "DIANA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "6260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teddy Willis Burke, DDS
• Samantha Marie Kallberg, PSYD, LP
• Samantha Kallberg (Dr Samantha Kallberg PSYD LP)

• Psychologist in Hampton, MN
• Providers in Hampton, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.