NATHAN RAUSCHENDORFER (LICSW) – Clinical Social Worker, NPI 1235382169

NATHAN RAUSCHENDORFER (LICSW) is a healthcare provider. based in Roseville, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 17535 (MN). The NPI Number for NATHAN RAUSCHENDORFER (LICSW) is 1235382169

Main info

Male
21 Years Of Experience
Name
NATHAN RAUSCHENDORFER (LICSW)
NPI
1235382169
Phone
(612) 708-7712
Address
2233 HAMLINE AVE N
Enumeration Date
23 October 2008
Last Update Date
28 September 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6127087712
Graduation Year
2005 (21 years ago)
PAC ID
9931247111
Group Practice PAC ID
3274890140
Professional Enrollment ID
I20091109000305
Address ID
MN551135023RO2233XNXXX401
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

2,310 CLINICAL SOCIAL WORKER in MN

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Provider Addresses for NATHAN RAUSCHENDORFER (LICSW)

  • 2233, Hamline Avenue North, Roseville, Ramsey County, Minnesota, 55113, United States

    STE 435

    ROSEVILLE, MN 551135023

    Phone: (612) 708-7712

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-11-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20091109000305IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55113)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274890140View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Clinical Social WorkerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

Does NATHAN RAUSCHENDORFER (LICSW) have a public NPI I can cite?
Public records show NATHAN RAUSCHENDORFER (LICSW) under NPI 1235382169.
Is NATHAN RAUSCHENDORFER (LICSW)'s NPI status active today?
Active status means NATHAN RAUSCHENDORFER (LICSW)'s NPI record is not deactivated in the public file.
What type of care does NATHAN RAUSCHENDORFER (LICSW) provide?
NATHAN RAUSCHENDORFER (LICSW)'s profile centers on Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is NATHAN RAUSCHENDORFER (LICSW) tied to Roseville, Minnesota?
If you are local to Roseville, Minnesota, NATHAN RAUSCHENDORFER (LICSW) may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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