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KELLY JO ORTENBLAD MSW, LICSW
NPI 1811598667
Social Worker - Clinical in Coon Rapids, MN

Active since November 06, 2020PECOS EnrolledAccepts Medicare Assignment
83.53/100
CMS Quality Rating
9055 SPRINGBROOK DR NW, COON RAPIDS, MN 55433(763) 780-9155(763) 236-1066 Get Directions Write a Review

NPPES record last updated: June 29, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 4, 2022, Nov 6, 2020 (2 updates tracked since 2020).

About Kelly Jo Ortenblad Msw, Licsw NPPES

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

KELLY JO ORTENBLAD MSW, LICSW (NPI 1811598667) is an individual clinical provider in Coon Rapids, Minnesota, licensed in Minnesota (26714) and active in the NPI registry since November 2020. She is enrolled in Medicare PECOS, is affiliated with Allina United Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1811598667
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKELLY JO ORTENBLADCredential: MSW, LICSW
Location Address9055 SPRINGBROOK DR NWCoon Rapids, MN 55433-5841
Mailing Address2925 Chicago AveMinneapolis, MN 55407-1321 · (612) 262-4400
Phone(763) 780-9155
Fax(763) 236-1066
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 6, 2020
Last NPPES UpdateJune 29, 20222 updates tracked since enumeration
NPPES CertifiedJune 29, 2022
✔ NPI 1811598667 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 · 26714
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.
9055 SPRINGBROOK DR NW, Coon Rapids, MN 55433
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Jo Ortenblad Msw, 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 ID941613582
PECOS Enrollment IDI20201229000019
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.

Areas of Expertise CMS Part B claims 2

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.

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.
188 services20 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.
44 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Allina United Hospital

Acute Care Hospitals · Saint Paul, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240038
Location333 North Smith AvenueSaint Paul, MN 55102 · Ramsey County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55433 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.

83.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.79
Promoting Interoperability100
Improvement Activities40
Cost63.31

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.

BLYTHE ELLEN NELSON LICSW
Social Worker (Clinical)
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Anoka County (763) 780-9155
DR. SUZANNE T WITTERHOLT MD
Psychiatry & Neurology (Pain Medicine)
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Anoka County (763) 780-9155
ABBY O'KEEFE STANISLAW PSYD
Psychologist (Clinical)
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Anoka County (763) 780-9155
MONICA YUE AUD
Audiologist
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Anoka County (763) 780-9155
EMILY BUTLER STRANGE DPT
Physical Therapist
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Anoka County (763) 780-9155
MARK H. BRAKKE MD
Family Medicine
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Anoka County (763) 780-9155
NATALIA YAZIGI M.D.
Internal Medicine
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Anoka County (763) 780-9155
STEPHANIE LANE FENNESSEY MS, RD, LD, CDE
Dietitian, Registered
9055 SPRINGBROOK DR NW
COON RAPIDS, MN 55433
Anoka County (763) 780-9155

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 Ortenblad's NPI number?

The NPI number for Kelly Ortenblad is 1811598667. It was assigned to this individual provider in the NPPES registry on November 6, 2020.

Where is Kelly Ortenblad located?

Kelly Ortenblad practices at 9055 Springbrook Dr NW, Coon Rapids, MN 55433. The listed phone number is (763) 780-9155.

What is Kelly Ortenblad's specialty?

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

Is Kelly Ortenblad enrolled in Medicare?

Yes. Kelly Ortenblad 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.

Is Kelly Ortenblad affiliated with any hospitals?

According to CMS data, Kelly Ortenblad is affiliated with Allina United Hospital.

When was this NPI record last updated?

The NPPES record for Kelly Ortenblad was last updated on June 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.