DR. WILLIAM RANDALL KREUSSER (PSYD LP) – Clinical Psychologist, NPI 1912987579

DR. WILLIAM RANDALL KREUSSER (PSYD LP) is a healthcare provider. based in Stillwater, Minnesota. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD LP. They hold a License No. LP4143 (MN). The NPI Number for DR. WILLIAM RANDALL KREUSSER (PSYD LP) is 1912987579

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
DR. WILLIAM RANDALL KREUSSER (PSYD LP)
NPI
1912987579
Phone
(651) 439-4840
Address
1875 NORTHWESTERN AVE S
Enumeration Date
19 January 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6516453115
Graduation Year
1997 (29 years ago)
PAC ID
4284670084
Group Practice PAC ID
3779633912
Professional Enrollment ID
I20050701000405
Address ID
MN551141052SA2550XWXXX408
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 DR. WILLIAM RANDALL KREUSSER (PSYD LP)

  • 1875, Northwestern Avenue, Stillwater, Washington County, Minnesota, 55082, United States

    STILLWATER, MN 550827534

    Phone: (651) 439-4840

    Fax: (651) 439-4894

    Type: Mailing

  • 1099, Helmo Avenue North, Oakdale, Washington County, Minnesota, 55128, United States

    SUITE 250

    OAKDALE, MN 551286033

    Phone: (651) 439-4840

    Fax: (651) 439-4894

    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: 2005-07-01

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
I20050701000405IClinical 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 55082)

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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: 3779633912View full group profile
NameSpecialtyState
P S Y C H I A T R YMN
Clinical Social WorkerMN
Certified Clinical Nurse Specialist (Cns)MN
Clinical Social WorkerMN
Nurse PractitionerMN
Nurse PractitionerMN
Clinical Social WorkerMN
Clinical PsychologistMN
Marriage And Family TherapistMN
Clinical Social WorkerMN

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Frequently asked questions

How do I look up DR. WILLIAM RANDALL KREUSSER (PSYD LP) by NPI?
Use NPI 1912987579 when you need to reference DR. WILLIAM RANDALL KREUSSER (PSYD LP) in forms, claims, or directories.
Is DR. WILLIAM RANDALL KREUSSER (PSYD LP)'s NPI currently valid?
The extract we use shows DR. WILLIAM RANDALL KREUSSER (PSYD LP) as active.
Can you summarize DR. WILLIAM RANDALL KREUSSER (PSYD LP)'s specialty in plain language?
Clinically, the directory lists DR. WILLIAM RANDALL KREUSSER (PSYD LP) with Clinical Psychologist. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. WILLIAM RANDALL KREUSSER (PSYD LP)?
The page summarizes Stillwater, Minnesota for DR. WILLIAM RANDALL KREUSSER (PSYD LP); expand the address list for detail.
Is DR. WILLIAM RANDALL KREUSSER (PSYD LP) a real provider?
This page reflects official NPPES data for NPI 1912987579. Always confirm identity and privileges with the practice and licensing boards.

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