DR. MATTHEW KINGSBURY PSYD, LP
NPI 1104224120
Psychologist in Maple Grove, MN

Active since December 08, 2014PECOS EnrolledAccepts Medicare Assignment
11316 86TH AVE N, MAPLE GROVE, MN 55369(763) 400-8000(763) 400-8000 Get Directions Write a Review

NPPES record last updated: July 12, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 12, 2022, Jun 2, 2021 (2 updates tracked since 2021).

About Dr. Matthew Kingsbury Psyd, Lp NPPES

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

DR. MATTHEW KINGSBURY PSYD, LP (NPI 1104224120) is an individual psychologist in Maple Grove, Minnesota, licensed in Minnesota (LP6684) and active in the NPI registry since December 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1104224120
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. MATTHEW KINGSBURYCredential: PSYD, LP
Location Address11316 86TH AVE NMaple Grove, MN 55369-4528
Mailing Address11316 86th Ave NMaple Grove, MN 55369-4528 · (763) 400-8000 · Fax (651) 426-8116
Fax(763) 400-8000
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateDecember 8, 2014
Last NPPES UpdateJuly 12, 20222 updates tracked since enumeration
NPPES CertifiedJuly 12, 2022
NPI 1104224120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP6684
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
11316 86TH AVE N, Maple Grove, MN 55369

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Matthew Kingsbury Psyd, Lp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062894884
PECOS Enrollment IDI20220726003250
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.

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 Matthew Kingsbury's NPI number?

The NPI number for Matthew Kingsbury is 1104224120. It was assigned to this individual provider in the NPPES registry on December 8, 2014.

Where is Matthew Kingsbury located?

Matthew Kingsbury practices at 11316 86th Ave N, Maple Grove, MN 55369. The listed phone number is (763) 400-8000.

What is Matthew Kingsbury's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Matthew Kingsbury enrolled in Medicare?

Yes. Matthew Kingsbury is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Matthew Kingsbury accept?

Health plans from HealthPartners list Matthew Kingsbury as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Matthew Kingsbury was last updated on July 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.