BEWELL PSYCHOTHERAPY PLLC
NPI 1346819307
Psychologist in Saint Paul, MN

Active since June 23, 2021
1821 UNIVERSITY AVE W STE 461-9, SAINT PAUL, MN 55104(612) 421-3178(612) 421-3183 Get Directions Write a Review

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

Record update history: Nov 3, 2021, Jun 23, 2021 (2 updates tracked since 2021).

About Bewell Psychotherapy Pllc NPPES

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

BEWELL PSYCHOTHERAPY PLLC (NPI 1346819307) is a healthcare organization registered as a psychologist in Saint Paul, Minnesota and active in the NPI registry since June 2021. The organization lists Ross Elliot Gubrud, Md Owner, as its authorized official.

NPPES Registry Identity

NPI1346819307
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameBEWELL PSYCHOTHERAPY PLLC
Location Address1821 UNIVERSITY AVE W STE 461-9Saint Paul, MN 55104-2801
Mailing Address3501 Xenium Ln N Apt 123Minneapolis, MN 55441-2222 · (612) 421-3187 · Fax (612) 421-3183
Fax(612) 421-3183
Organization SubpartNo
Authorized OfficialRoss Elliot GubrudMd Owner · (612) 421-3187
Enumeration DateJune 23, 2021
Last NPPES UpdateOctober 31, 20252 updates tracked since enumeration
NPPES CertifiedOctober 31, 2025
✔ NPI 1346819307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
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 · ClinicalTaxonomy 103TC0700X
1821 UNIVERSITY AVE W STE 461-9, Saint Paul, MN 55104

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bewell Psychotherapy Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMinnesotaEnrollment IDO20220119000541Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Bewell Psychotherapy PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Psychologist Billing Independently
NPI 1285166355
1821 UNIVERSITY AVE W STE 461-9
Saint Paul, MN 55104
(612) 421-3178
0.2 mi

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

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 Bewell Psychotherapy PLLC's NPI number?

The NPI number for Bewell Psychotherapy PLLC is 1346819307. It was assigned to this organization in the NPPES registry on June 23, 2021.

Where is Bewell Psychotherapy PLLC located?

Bewell Psychotherapy PLLC is located at 1821 University Ave W Ste 461-9, Saint Paul, MN 55104. The listed phone number is (612) 421-3178.

What is Bewell Psychotherapy PLLC's specialty?

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

Is Bewell Psychotherapy PLLC enrolled in Medicare?

Yes. Bewell Psychotherapy PLLC is registered in the Medicare PECOS enrollment system.

When is Bewell Psychotherapy PLLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Minnesota, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Bewell Psychotherapy PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Psychologist Billing Independently) reassigns their Medicare billing to Bewell Psychotherapy PLLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bewell Psychotherapy PLLC was last updated on October 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.