Ethan McCallum, PHD
NPI 1851703110ActiveIndividual· Psychologist· Plymouth, MN
Psychologist (PHD) in Plymouth, Minnesota, trained at University of Missouri, Kansas City, School of Medicine (class of 2013). Medicare paid $5,662 for services to 14 patients in 2024.
Overview
| NPI | 1851703110 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | Yes |
| NPI issued | May 21, 2014 |
| Last updated in NPPES | Nov 10, 2020 |
| Certified by provider | Nov 10, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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 | 14 |
|---|---|
| Services billed | 71 across 4 procedure codes |
| Paid by Medicare | $5,662 |
Education and affiliations
| Medical school | University of Missouri, Kansas City, School of Medicine |
|---|---|
| Graduation year | 2013 |
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
Medical group
- Allina Health SystemNew Ulm, MN · 3,842 clinicians
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