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ELLEN THERESE GORMICAN LICSW
NPI 1093698490
Psychologist - Clinical in Minneapolis, MN

Active since July 31, 2025PECOS Enrolled
3236 LONGFELLOW AVE, MINNEAPOLIS, MN 55407(612) 807-6872 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ellen Therese Gormican Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELLEN THERESE GORMICAN LICSW (NPI 1093698490) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (30671) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1093698490
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameELLEN THERESE GORMICANCredential: LICSW
Location Address3236 LONGFELLOW AVEMinneapolis, MN 55407-3805
Mailing Address3236 Longfellow AveMinneapolis, MN 55407-3805 · (612) 807-6872
Phone(612) 807-6872
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateJuly 31, 2025
NPPES CertifiedJuly 31, 2025
✔ NPI 1093698490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MN · 30671
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
3236 LONGFELLOW AVE, Minneapolis, MN 55407
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ellen Therese Gormican Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4789154147
PECOS Enrollment IDI20260527000766
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ellen Gormican reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PA
1,509 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Minnesota enrollment
  • 276 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55407 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$168.28 typical visit price
range $56.00 – $168.28
Typical copayment $42.07 (range $14.00 – $42.07)
Most-billed visit code 99205
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellen Gormican's NPI number?

The NPI number for Ellen Gormican is 1093698490. It was assigned to this individual provider in the NPPES registry on July 31, 2025.

Where is Ellen Gormican located?

Ellen Gormican practices at 3236 Longfellow Ave, Minneapolis, MN 55407. The listed phone number is (612) 807-6872.

What is Ellen Gormican's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Ellen Gormican enrolled in Medicare?

Yes. Ellen Gormican is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ellen Gormican's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ellen Gormican reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ellen Gormican's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ellen Gormican was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.