DOUGLAS MICHAEL WHITESIDE (PHD) – Psychologist, NPI 1346280971
Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,110 CLINICAL PSYCHOLOGIST in MN
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Provider Addresses for DOUGLAS MICHAEL WHITESIDE (PHD)
Washington Avenue Southeast, Prospect Park - East River Road, Minneapolis, Hennepin County, Minnesota, 55414, United States
MINNEAPOLIS, MN 554142904
Phone:
Type: Mailing
University of Minnesota Health Clinics and Surgery Center, 909, Fulton Street Southeast, Prospect Park - East River Road, Minneapolis, Hennepin County, Minnesota, 55455, United States
MINNEAPOLIS, MN 554554800
Phone: (612) 672-7422
Type: Location
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: 2019-12-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20191212001290 | I | Clinical Psychologist | MN | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96139 | Administration of psychological or neuropsychological test by technician, each additional 30 minutes | 233 | 46 | $0 |
| 96133 | Evaluation of neuropsychological test, each additional hour | 155 | 48 | $0 |
| 90791 | Psychiatric diagnostic evaluation | 51 | 49 | $0 |
| 96132 | Evaluation of neuropsychological test, first hour | 50 | 48 | $0 |
| 96138 | Administration of psychological or neuropsychological test by technician, first 30 minutes | 47 | 46 | $0 |
Insurance plans in this area (ZIP 55414)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | MN | |
| G A S T R O E N T E R O L O G Y | MN | |
| N E U R O S U R G E R Y | OH | |
| - | MN | |
| Physician Assistant | MN | |
| Physician Assistant | MN | |
| - | MN | |
| - | MN | |
| Physical Therapist In Private Practice | OR | |
| Cardiovascular Disease (Cardiology) | IL |
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