KOTATEE TAMBA LP, LICSW
NPI 1366852972
Psychologist in Minneapolis, MN

Active since May 05, 2014PECOS EnrolledAccepts Medicare Assignment
2500 2ND ST NE APT 607, MINNEAPOLIS, MN 55418(651) 497-9483 Get Directions Write a Review

NPPES record last updated: November 4, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kotatee Tamba Lp, Licsw NPPES

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

KOTATEE TAMBA LP, LICSW (NPI 1366852972) is an individual psychologist in Minneapolis, Minnesota, licensed in Minnesota (LP7120) and active in the NPI registry since May 2014. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1366852972
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameKOTATEE TAMBACredential: LP, LICSW
Location Address2500 2ND ST NE APT 607Minneapolis, MN 55418-3588
Mailing AddressPo Box 977Owatonna, MN 55060-0977 · (507) 446-0431
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMay 5, 2014
Last NPPES UpdateNovember 4, 2024
NPPES CertifiedNovember 4, 2024
✔ NPI 1366852972 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 · LP7120
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 ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 21317 (MN)
2500 2ND ST NE APT 607, Minneapolis, MN 55418

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kotatee Tamba Lp, Licsw 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 ID5698007268
PECOS Enrollment IDI20191031000918
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 Reassignments

2

Medicare enrollment records show Kotatee Tamba reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mental Health (Including Community Mental Health Center)
1915 LYNDALE AVE S
Minneapolis, MN 55403
  • Reassigned Medicare billing, Minnesota enrollment
  • 60 clinicians in this Medicare group
Substance Abuse Rehabilitation Facility
2626 E 82ND ST STE 335
Bloomington, MN 55425
  • Reassigned Medicare billing, Minnesota enrollment
  • 9 clinicians in this Medicare group

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 Kotatee Tamba's NPI number?

The NPI number for Kotatee Tamba is 1366852972. It was assigned to this individual provider in the NPPES registry on May 5, 2014.

Where is Kotatee Tamba located?

Kotatee Tamba practices at 2500 2nd St NE Apt 607, Minneapolis, MN 55418. The listed phone number is (651) 497-9483.

What is Kotatee Tamba's specialty?

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

Is Kotatee Tamba enrolled in Medicare?

Yes. Kotatee Tamba 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.

Which organizations bill Medicare for Kotatee Tamba's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kotatee Tamba reassigns Medicare benefits to 2 organizations: Catalyst Mental Health, Gbc (Minneapolis, MN) and Midwest Recovery, Inc (Bloomington, MN). Each 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 Kotatee Tamba's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kotatee Tamba accept?

Health plans from HealthPartners list Kotatee Tamba 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 Kotatee Tamba was last updated on November 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.