Mark Alan Rosenblum, PSYD, LP
NPI 1053526731ActiveIndividual· Psychologist, Clinical· Detroit Lakes, MN
Psychologist, Clinical (PSYD, LP) with St Marys Regional Health Center, practicing in Detroit Lakes, Minnesota. Medicare paid $3,018 for services to 21 patients in 2024. Lists Hennepin County Medical Center as a hospital affiliation.
Overview
| NPI | 1053526731 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD, LP |
| Sole proprietor | No |
| NPI issued | May 14, 2007 |
| Last updated in NPPES | Jul 17, 2026 |
| Certified by provider | Jul 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | LP4815 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 21 |
|---|---|
| Services billed | 51 across 3 procedure codes |
| Paid by Medicare | $3,018 |
Education and affiliations
| Graduation year | 2006 |
|---|---|
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Medical group
- St Marys Regional Health CenterMenahga, MN · 190 clinicians
Hospital affiliation
- Hennepin County Medical CenterMinneapolis, MN
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