RYAN MICHAEL ENGDAHL (PHD, LP) – Clinical Psychologist, NPI 1407148588

RYAN MICHAEL ENGDAHL (PHD, LP) is a healthcare provider. based in St. cloud, Minnesota. specializing in Clinical Psychologist. They hold the professional credentials PHD, LP. They hold a License No. LP5519 (MN). The NPI Number for RYAN MICHAEL ENGDAHL (PHD, LP) is 1407148588

Main info

Male
Name
RYAN MICHAEL ENGDAHL (PHD, LP)
NPI
1407148588
Phone
(320) 229-5199
Address
1900 CENTRA CARE CIRCLE #2475
Enumeration Date
9 May 2011
Last Update Date
12 October 2012
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for RYAN MICHAEL ENGDAHL (PHD, LP)

  • 1900 CENTRA CARE CIRCLE #2475

    CENTRA CARE HEALTH PLAZA

    ST. CLOUD, MN 563035000

    Phone: (320) 229-5199

    Fax: (320) 229-5109

    Type: Mailing

  • 1406 6TH AVENUE NORTH

    ST. CLOUD HOSPITAL

    ST. CLOUD, MN 563031901

    Phone: (320) 251-2700

    Fax: (320) 229-5109

    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: 2012-12-26

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
I20121226000099IClinical 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 56303)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for RYAN MICHAEL ENGDAHL (PHD, LP)?
RYAN MICHAEL ENGDAHL (PHD, LP) — NPI 1407148588 — is the standard way to identify this listing.
Is RYAN MICHAEL ENGDAHL (PHD, LP) still practicing?
RYAN MICHAEL ENGDAHL (PHD, LP) is currently listed as active in the public NPI registry.
What is RYAN MICHAEL ENGDAHL (PHD, LP)'s primary classification?
Clinical Psychologist is the headline specialty for RYAN MICHAEL ENGDAHL (PHD, LP) here. Clinical services aligned with this taxonomy classification.
Where should I expect RYAN MICHAEL ENGDAHL (PHD, LP) on a map?
Expect St. Cloud, Minnesota as a primary anchor for RYAN MICHAEL ENGDAHL (PHD, LP) unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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