THOMAS EDWARD BENIAK (NPI# 1043227515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043227515 |
| Entity Type | Individual |
| Full Name | THOMAS EDWARD BENIAK |
| Credential | PHD |
| Practice Address |
5775 Wayzata Blvd Ste 200 Minneapolis MN 55416-1227 |
| Practice Telephone | 9525254511 |
| Practice Fax Number | 9525251560 |
| Mailing Telephone | 9525254511 |
| Mailing Fax Number | 9525251560 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | LP0706 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICA | 15-82098 | 01 | |
| PREFERRED ONE | 01014969 | 01 | |
| ND | 10088 | 05 | |
| TRIWEST | A015 | 01 | |
| HEALTHPARTNERS | HP37238 | 01 | |
| AMERICAS PPO | 765445 | 01 | |
| BLUE CROSS BLUE SHIELD | 71318BE | 01 |
| Street Address |
5775 WAYZATA BLVD STE 200 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55416-1227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538174073 | Ilo Elmar Leppik | Psychiatry & Neurology | 5775 Wayzata Blvd Ste 200, Minneapolis, MN 55416-1227 | 2006-07-31 |
| 1043350366 | Sima Indubhai Patel | Psychiatry & Neurology | 5775 Wayzata Blvd Ste 200, Minneapolis, MN 55416-1227 | 2007-02-07 |
| 1023023561 | Lorna Lee Rupp | Nurse Practitioner | 5775 Wayzata Blvd Ste 200, Minneapolis, MN 55416-1227 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285118687 | Chimei M Lee | Clinical Neuropsychologist | 717 Delaware St Se Ste 340, Minneapolis, MN 55414-2959 | 2018-09-20 |
| 1962750026 | Paul Marshall LLC | Clinical Neuropsychologist | 825 Nicollet Mall Ste 1440, Medical Arts Bldg, Minneapolis, MN 55402-2718 | 2012-08-21 |
| 1780977934 | Samantha Glass | Clinical Neuropsychologist | 701 Park Ave # G8, Minneapolis, MN 55415-1623 | 2011-05-20 |
| 1467660084 | Robin Lee Wetzel | Clinical Neuropsychologist | 1625 Park Ave, Minneapolis, MN 55404-1634 | 2007-05-18 |
| 1912022336 | Learning and Language Specialists, Inc. | Clinical Neuropsychologist | 1405 Lilac Dr N Ste 200, Minneapolis, MN 55422-4546 | 2007-03-21 |
| 1619050028 | Robin Rumsey | Clinical Neuropsychologist | 717 Delaware St Se Ste 240, Minneapolis, MN 55414-2959 | 2006-10-23 |
| 1497837041 | William Thomas O'dowd | Clinical Neuropsychologist | 2720 W 43rd St, Suite 205, Minneapolis, MN 55410-1643 | 2006-10-20 |
| 1568418812 | Christopher James Boys | Clinical Neuropsychologist | 200 Oak St Se, 160 Mcnamara Mcnamara, University of Minnesota Physicians, Minneapolis, MN 55455 | 2006-05-26 |
| 1649819665 | Amanda Wenzel Kalstabakken | Clinical Neuropsychologist | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2019-12-23 |
| 1104476589 | Leslie N Perez | Clinical Neuropsychologist | 701 Park Ave, Minneapolis, MN 55415-1623 | 2019-09-17 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55416 |
Please comment or provide details below to improve the information on THOMAS EDWARD BENIAK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.