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TRESSA KAY REISETTER PHD, LP, NCSP
NPI 1467597567
Clinical Neuropsychologist in Big Lake, MN

Active since February 20, 2007Opted out of Medicare · through Jul 1, 2027
621 RED OAK DR, BIG LAKE, MN 55309(612) 597-2737 Get Directions Write a Review

NPPES record last updated: April 17, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 17, 2020, Mar 12, 2020, May 29, 2019 (3 updates tracked since 2019).

About Tressa Kay Reisetter Phd, Lp, Ncsp NPPES

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

TRESSA KAY REISETTER PHD, LP, NCSP (NPI 1467597567) is an individual clinical neuropsychologist in Big Lake, Minnesota, licensed in Minnesota (LP4752) and active in the NPI registry since February 2007. She has opted out of Medicare through July 1, 2027.

NPPES Registry Identity

NPI1467597567
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameTRESSA KAY REISETTERCredential: PHD, LP, NCSP
Location Address621 RED OAK DRBig Lake, MN 55309-9585
Mailing Address621 Red Oak DrBig Lake, MN 55309-9585 · (612) 597-2737 · Fax (763) 566-2944
Phone(612) 597-2737
Sole ProprietorNo
Enumeration DateFebruary 20, 2007
Last NPPES UpdateApril 17, 20203 updates tracked since enumeration
NPPES CertifiedApril 17, 2020
✔ NPI 1467597567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in MN · LP4752
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 2019014342 (MO)
621 RED OAK DR, Big Lake, MN 55309
Open in Google Maps ↗

Other Identifiers 1

Other14450911Caqh

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Tressa Kay Reisetter Phd, Lp, Ncsp has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2025 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2025
Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

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

PSYCHOLOGICAL ASSESSMENT SERVICES
Psychologist (Clinical Child & Adolescent)
621 RED OAK DR
BIG LAKE, MN 55309
Sherburne County (612) 597-2737

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 Tressa Reisetter's NPI number?

The NPI number for Tressa Reisetter is 1467597567. It was assigned to this individual provider in the NPPES registry on February 20, 2007.

Where is Tressa Reisetter located?

Tressa Reisetter practices at 621 Red Oak Dr, Big Lake, MN 55309. The listed phone number is (612) 597-2737.

What is Tressa Reisetter's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Tressa Reisetter enrolled in Medicare?

No. Tressa Reisetter has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Tressa Reisetter was last updated on April 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.