DR. MARYANNE SARAH EDMUNDSON PHD, LP
NPI 1609393628
Psychologist - Clinical in Golden Valley, MN

Q: What is Maryanne Edmundson's NPI number?

The NPI number for Maryanne Edmundson is 1609393628. It was assigned to this individual provider in the NPPES registry on August 30, 2017.

Q: What is Maryanne Edmundson's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Active since August 30, 2017PECOS EnrolledAccepts Medicare Assignment

4225 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422(763) 588-0661(763) 287-2303 Get Directions Write a Review

NPPES record last updated: May 20, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 20, 2026, Mar 5, 2026, Jul 21, 2022 and 1 more (4 updates tracked since 2017).

On this page

About Dr. Maryanne Sarah Edmundson Phd, Lp NPPES

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

DR. MARYANNE SARAH EDMUNDSON PHD, LP (NPI 1609393628) is an individual clinical provider in Golden Valley, Minnesota, licensed in Minnesota (LP6135) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1609393628

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. MARYANNE SARAH EDMUNDSONCredential: PHD, LP

Location Address4225 GOLDEN VALLEY RDGolden Valley, MN 55422-4215

Mailing Address4225 Golden Valley RdGolden Valley, MN 55422-4215 · (763) 588-0661 · Fax (763) 287-2303

Phone(763) 588-0661

Fax(763) 287-2303

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateAugust 30, 2017

Last NPPES UpdateMay 20, 20264 updates tracked since enumeration

NPPES CertifiedMay 20, 2026

✔ NPI 1609393628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in MN · LP6135

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedClinical NeuropsychologistTaxonomy 103G00000X · License LP6135 (MN)

4225 GOLDEN VALLEY RD, Golden Valley, MN 55422

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.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

Dr. Maryanne Sarah Edmundson 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 ID5092081364

PECOS Enrollment IDI20171101001541, I20260318001308

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

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

Minneapolis Clinic Of Neurology, Ltd

Same address

Neurology

4225 GOLDEN VALLEY RD
Golden Valley, MN 55422

Reassigned Medicare billing, Minnesota enrollment
80 clinicians in this Medicare group

NPI 1992739247 (763) 588-0661

Pinehurst Neuropsychology, PLLC

996 mi

Psychologist

45 AVIEMORE DR
Pinehurst, NC 28374

Reassigned Medicare billing, North Carolina enrollment
2 clinicians in this Medicare group

NPI 1588099618 (919) 420-8041

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

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of psychological or neuropsychological test by technician, each additional 30 minutes 96139

This service involves a technician administering additional psychological or neuropsychological testing. Each session lasts for an extra 30 minutes. These tests assess cognitive abilities, such as memory, attention, and problem-solving skills, to aid in diagnosing or monitoring mental health conditions.

968 services90 patients

Evaluation of neuropsychological test, each additional hour 96133

This service involves further evaluation of your neuropsychological test results beyond the initial hour. It helps to understand your cognitive functioning better, focusing on areas like memory, attention, and problem-solving skills.

462 services95 patients

Evaluation of neuropsychological test, first hour 96132

An evaluation of neuropsychological tests is a process to assess your brain's function. It involves tasks designed to measure cognitive abilities such as memory, attention, problem-solving, and language skills. The first hour involves initial testing and observation.

95 services95 patients

Administration of psychological or neuropsychological test by technician, first 30 minutes 96138

This procedure involves a trained technician administering a psychological or neuropsychological test. It's a process that assesses your mental function and behavior. The initial session will last 30 minutes. The aim is to understand your cognitive abilities better.

90 services90 patients

Psychiatric diagnostic evaluation 90791

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

87 services87 patients

Psychotherapy, 1 hour 90837

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.

78 services27 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55422 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$168.28 typical visit price

range $56.00 – $168.28

Typical copayment $42.07 (range $14.00 – $42.07)

Most-billed visit code 99205

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

BRENT BERRY M.D./PH.D.

Psychiatry & Neurology (Neurology)