JON COLOMBO – Clinical Psychologist, NPI 1609865674

JON COLOMBO is a healthcare provider. based in Lake elmo, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold a License No. LP 5165 (MN). The NPI Number for JON COLOMBO is 1609865674

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
JON COLOMBO
NPI
1609865674
Phone
(651) 379-0444
Address
8669 EAGLE POINT BLVD
Enumeration Date
20 October 2005
Last Update Date
15 December 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
65137904444
Graduation Year
2008 (18 years ago)
PAC ID
9234394537
Group Practice PAC ID
0749271781
Professional Enrollment ID
I20120712000423
Address ID
MN550428628LA8669XBLVD400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,110 CLINICAL PSYCHOLOGIST in MN

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Provider Addresses for JON COLOMBO

  • Eagle Point Boulevard, Lake Elmo, Washington County, Minnesota, 55125, United States

    LAKE ELMO, MN 550428628

    Phone: (651) 379-0444

    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: 2012-07-12

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120712000423IClinical PsychologistMNTBD

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 55042)

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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: 0749271781View full group profile
NameSpecialtyState
Marriage And Family TherapistMN
Clinical PsychologistMN
-MN
Mental Health CounselorMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Clinical Social WorkerMN
Nurse PractitionerMN
Marriage And Family TherapistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

What identifier follows JON COLOMBO across health systems?
The NPI 1609865674 uniquely identifies JON COLOMBO in U.S. healthcare data.
Does the public listing show JON COLOMBO as active?
JON COLOMBO's NPI record reflects an active status in NPPES.
Which specialty label fits JON COLOMBO?
NPPES ties JON COLOMBO to Clinical Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit JON COLOMBO in Lake Elmo, Minnesota?
For routing, start with Lake Elmo, Minnesota for JON COLOMBO, then verify phone and hours locally.
Who maintains JON COLOMBO's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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