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SHAWN RAE DISTERHAUPT
NPI 1942996087
Social Worker - Clinical in Brainerd, MN

Active since April 12, 2023PECOS Enrolled
606 FRONT ST, BRAINERD, MN 56401(218) 232-6247 Get Directions Write a Review

NPPES record last updated: April 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shawn Rae Disterhaupt NPPES

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

SHAWN RAE DISTERHAUPT (NPI 1942996087) is an individual clinical provider in Brainerd, Minnesota, licensed in Minnesota (26111) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1942996087
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameSHAWN RAE DISTERHAUPT
Location Address606 FRONT STBrainerd, MN 56401-3602
Mailing Address203 H St NeBrainerd, MN 56401-2404
Phone(218) 232-6247
Sole ProprietorNo
Enumeration DateApril 12, 2023
NPPES CertifiedApril 12, 2023
✔ NPI 1942996087 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 · 26111
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.
606 FRONT ST, Brainerd, MN 56401
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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shawn Rae Disterhaupt 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56401 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.

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.

TAMARA KMECIK LICSW
Social Worker
606 FRONT ST
BRAINERD, MN 56401
Crow Wing County (320) 360-8486
DANA MARIE DALLY-CLEYS LADC
Counselor (Addiction (Substance Use Disorder))
606 FRONT ST
BRAINERD, MN 56401
Crow Wing County (218) 838-9471

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 Shawn Disterhaupt's NPI number?

The NPI number for Shawn Disterhaupt is 1942996087. It was assigned to this individual provider in the NPPES registry on April 12, 2023.

Where is Shawn Disterhaupt located?

Shawn Disterhaupt practices at 606 Front St, Brainerd, MN 56401. The listed phone number is (218) 232-6247.

What is Shawn Disterhaupt's specialty?

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

Is Shawn Disterhaupt enrolled in Medicare?

Yes. Shawn Disterhaupt is registered in the Medicare PECOS enrollment system.

What insurance does Shawn Disterhaupt accept?

Health plans from HealthPartners list Shawn Disterhaupt 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 Shawn Disterhaupt was last updated on April 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.