SAMANTHA MARIE SORENSEN PSY.D., LP
NPI 1750625166
Psychologist in St Louis Park, MN

Active since November 26, 2012PECOS Enrolled
4601 EXCELSIOR BLVD STE 411, ST LOUIS PARK, MN 55416(763) 614-5060(763) 614-5060 Get Directions Write a Review

NPPES record last updated: September 27, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Samantha Marie Sorensen Psy.d., Lp NPPES

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

SAMANTHA MARIE SORENSEN PSY.D., LP (NPI 1750625166) is an individual psychologist in St Louis Park, Minnesota, licensed in Minnesota (LP5556) and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750625166
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameSAMANTHA MARIE SORENSENCredential: PSY.D., LP
Location Address4601 EXCELSIOR BLVD STE 411St Louis Park, MN 55416-4977
Mailing Address12331 Marmon St NeBlaine, MN 55449-6280 · (763) 350-9032
Fax(763) 614-5060
Sole ProprietorNo
Enumeration DateNovember 26, 2012
Last NPPES UpdateSeptember 27, 2021
NPPES CertifiedSeptember 27, 2021
✔ NPI 1750625166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MN · LP5556
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.
4601 EXCELSIOR BLVD STE 411, St Louis Park, MN 55416

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha Marie Sorensen Psy.d., Lp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Samantha Sorensen reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

General Acute Care Hospital
6401 FRANCE AVE S
Edina, MN 55435
  • Reassigned Medicare billing, Minnesota enrollment
  • 4,038 clinicians in this Medicare group
Physical Therapy
2450 RIVERSIDE AVE
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,373 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.

Other Providers at the Same Location NPPES 2

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

Psychologist (Counseling)
4601 EXCELSIOR BLVD STE 411
ST LOUIS PARK, MN 55416
Psychologist (Counseling)
4601 EXCELSIOR BLVD STE 411
ST LOUIS PARK, MN 55416

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 Samantha Sorensen's NPI number?

The NPI number for Samantha Sorensen is 1750625166. It was assigned to this individual provider in the NPPES registry on November 26, 2012.

Where is Samantha Sorensen located?

Samantha Sorensen practices at 4601 Excelsior Blvd Ste 411, St Louis Park, MN 55416. The listed phone number is (763) 614-5060.

What is Samantha Sorensen's specialty?

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

Is Samantha Sorensen enrolled in Medicare?

Yes. Samantha Sorensen is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Samantha Sorensen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Sorensen reassigns Medicare benefits to 2 organizations: Fairview Health Services (Edina, MN) and Fairview Specialty Services (Minneapolis, 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 Samantha Sorensen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Samantha Sorensen accept?

Health plans from Sanford Health Plan list Samantha Sorensen 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 Samantha Sorensen was last updated on September 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.