Kerry Ryan Brockberg, PH.D., LP
NPI 1588179410ActiveIndividual· Psychologist· Minneapolis, MN
Psychologist (PH.D., LP) in Minneapolis, Minnesota, trained at University of Wisconsin School of Medicine (class of 2017). Medicare paid $26,452 for services to 11 patients in 2024.
Overview
| NPI | 1588179410 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D., LP |
| Sole proprietor | No |
| NPI issued | Dec 14, 2017 |
| Last updated in NPPES | May 18, 2021 |
| Certified by provider | May 18, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | LP6410 | 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 | 11 |
|---|---|
| Services billed | 265 across 5 procedure codes |
| Paid by Medicare | $26,452 |
Education and affiliations
| Medical school | University of Wisconsin School of Medicine |
|---|---|
| Graduation year | 2017 |
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Medical group
- Allina Health SystemNew Ulm, MN · 3,842 clinicians
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