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KELLY ANN TATE LICSW
NPI 1790323756
Social Worker - Clinical in Minneapolis, MN

Active since December 20, 2019PECOS Enrolled
81.72/100
CMS Quality Rating
401 HARDING ST NE STE 100, MINNEAPOLIS, MN 55413(612) 398-7000 Get Directions Write a Review

NPPES record last updated: December 20, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kelly Ann Tate Licsw NPPES

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

KELLY ANN TATE LICSW (NPI 1790323756) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (14704) and active in the NPI registry since December 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790323756
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY ANN TATECredential: LICSW
Location Address401 HARDING ST NE STE 100Minneapolis, MN 55413-2801
Mailing Address401 Harding St Ne Ste 100Minneapolis, MN 55413-2801 · (612) 398-7000
Phone(612) 398-7000
Sole ProprietorNo
Enumeration DateDecember 20, 2019
✔ NPI 1790323756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 14704
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
401 HARDING ST NE STE 100, Minneapolis, MN 55413
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Ann Tate Licsw 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 Kelly Tate reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Express Care
1.6 mi
Cardiovascular Disease
909 FULTON ST SE
Minneapolis, MN 55455
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,633 clinicians in this Medicare group
NPI 1629224258 (612) 625-3600
Healtheast Medical Research Institute
3.5 mi
Family Medicine
2680 SNELLING AVE N, SUITE 200
Roseville, MN 55113
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,361 clinicians in this Medicare group
NPI 1053620187 (651) 326-1800

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55413 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
$0.00 typical visit price
range $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.72/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.86
Promoting Interoperability100
Improvement Activities40
Cost59.73

Other Providers at the Same Location NPPES 11

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

CHRISTIN MARY AMENT CNP
Nurse Practitioner (Family)
401 HARDING ST NE STE 100
MINNEAPOLIS, MN 55413
Hennepin County (651) 571-0000
JENNA L BREIDINGER DNP, APRN, CNP
Nurse Practitioner (Family)
401 HARDING ST NE STE 100
MINNEAPOLIS, MN 55413
Hennepin County (612) 398-7000
MS. LISA M RENARD PAULE NP
Nurse Practitioner (Family)
401 HARDING ST NE STE 100
MINNEAPOLIS, MN 55413
Hennepin County (651) 571-0000
FAIZO A MOHAMMED LICSW
Social Worker (Clinical)
401 HARDING ST NE STE 100
MINNEAPOLIS, MN 55413
Hennepin County (612) 398-7000
COURTNEY E BJORKLUND LICSW
Social Worker (Clinical)
401 HARDING ST NE STE 100
MINNEAPOLIS, MN 55413
Hennepin County (612) 398-7000
AMY CHRISTINE ERICKSON KLOPP APRN, CNS, CNP
Nurse Practitioner
401 HARDING ST NE STE 100
MINNEAPOLIS, MN 55413
Hennepin County (612) 398-7000
MS. DEANNA EBERT C.N.P.
Nurse Practitioner (Family)
401 HARDING ST NE STE 100
MINNEAPOLIS, MN 55413
Hennepin County (651) 571-0000
TAIWO AFUYE MSN
Nurse Practitioner (Family)
401 HARDING ST NE STE 100
MINNEAPOLIS, MN 55413
Hennepin County (651) 571-0000

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 Kelly Tate's NPI number?

The NPI number for Kelly Tate is 1790323756. It was assigned to this individual provider in the NPPES registry on December 20, 2019.

Where is Kelly Tate located?

Kelly Tate practices at 401 Harding St NE Ste 100, Minneapolis, MN 55413. The listed phone number is (612) 398-7000.

What is Kelly Tate's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kelly Tate enrolled in Medicare?

Yes. Kelly Tate is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Kelly Tate's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Tate reassigns Medicare benefits to 2 organizations: Fairview Express Care (Minneapolis, MN) and Healtheast Medical Research Institute (Roseville, 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 Kelly Tate's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Tate was last updated on December 20, 2019. 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.