DR. JACKIE ENGEBRETSON PHD, LP
NPI 1134598667
Psychologist in Bloomington, MN

Active since September 15, 2015PECOS EnrolledAccepts Medicare Assignment
83.53/100
CMS Quality Rating
7920 OLD CEDAR AVE S, BLOOMINGTON, MN 55425(952) 428-1800 Get Directions Write a Review

NPPES record last updated: August 12, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Jackie Engebretson Phd, Lp NPPES

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

DR. JACKIE ENGEBRETSON PHD, LP (NPI 1134598667) is an individual psychologist in Bloomington, Minnesota, licensed in Minnesota (LP5917) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in St Louis Park, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1134598667
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. JACKIE ENGEBRETSONCredential: PHD, LP
Location Address7920 OLD CEDAR AVE SBloomington, MN 55425-1207
Mailing Address2925 Chicago AveMinneapolis, MN 55407-1321 · (612) 262-9000
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateSeptember 15, 2015
Last NPPES UpdateAugust 12, 2022
NPPES CertifiedAugust 12, 2022
NPI 1134598667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in MN · LP5917
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.
Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License LP5917 (MN)
7920 OLD CEDAR AVE S, Bloomington, MN 55425

Secondary Practice Location 1

Location 13850 Park Nicollet BlvdSt Louis Park, MN 55416-2527 · Phone (952) 993-1000

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. Jackie Engebretson Phd, 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 ID8224346994
PECOS Enrollment IDI20150929002313
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 Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.79
Promoting Interoperability100
Improvement Activities40
Cost63.31

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Audiologist-Hearing Aid Fitter
7920 OLD CEDAR AVE S
BLOOMINGTON, MN 55425
Family Medicine
7920 OLD CEDAR AVE S
BLOOMINGTON, MN 55425
Internal Medicine
7920 OLD CEDAR AVE S
BLOOMINGTON, MN 55425
Family Medicine
7920 OLD CEDAR AVE S
BLOOMINGTON, MN 55425
Pediatrics
7920 OLD CEDAR AVE S
BLOOMINGTON, MN 55425
Internal Medicine
7920 OLD CEDAR AVE S
BLOOMINGTON, MN 55425
Internal Medicine
7920 OLD CEDAR AVE S
BLOOMINGTON, MN 55425
Physician Assistant
7920 OLD CEDAR AVE S
BLOOMINGTON, MN 55425

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 Jackie Engebretson's NPI number?

The NPI number for Jackie Engebretson is 1134598667. It was assigned to this individual provider in the NPPES registry on September 15, 2015.

Where is Jackie Engebretson located?

Jackie Engebretson practices at 7920 Old Cedar Ave S, Bloomington, MN 55425. The listed phone number is (952) 428-1800.

What is Jackie Engebretson's specialty?

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

Is Jackie Engebretson enrolled in Medicare?

Yes. Jackie Engebretson 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.

When was this NPI record last updated?

The NPPES record for Jackie Engebretson was last updated on August 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.