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Dr. Mark Christopher Goetz , PhD

Psychologist β€’ Champlin, MN

Active NPI 1780978023 Individual Practitioner Male Practitioner
Practice location in NPPES

11269 Jefferson Hwy N
Champlin, MN 553163123

Call 7632360600 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

11269 Jefferson Hwy N

Champlin, MN 553163123

Telephone 7632360600
Organization at the Same NPPES Address or Phone
Allina Health System Facility NPI 1871899674

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2011

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Goetz has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Goetz as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Champlin and Minnesota

3 active clinicians are listed under Psychologist with a practice address in Champlin, MN (1,694 in Minnesota).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2021-04-09
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Psychologist - Rehabilitation

NUCC Taxonomy Code: 103TR0400X

A psychologist who specializes in the study and application of psychological principles on behalf of persons who have disability due to injury or illness. Rehabilitation psychologists, often within teams, assess and treat cognitive, emotional, and functional difficulties, and help people to overcome barriers to participation in life activities. Rehabilitation psychologists are involved in practice, research, and advocacy, with the broad goal of fostering independence and opportunity for people with disabilities.

Physical Medicine & Rehabilitation

NUCC Taxonomy Code: 208100000X

License # reported to NPPES WA PY60230406

Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.

Psychologist - Clinical

NUCC Taxonomy Code: 103TC0700X

License # reported to NPPES WA PY60230406

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Psychologist - Counseling

NUCC Taxonomy Code: 103TC1900X

A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.

Psychologist - Clinical Child & Adolescent

NUCC Taxonomy Code: 103TC2200X

License # reported to NPPES WA PY60230406

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

Psychologist - Family

NUCC Taxonomy Code: 103TF0000X

A psychologist whose specialty is founded on principles of systems theory with the interpersonal system of the family the focus of assessment, intervention and research.

Psychologist - Health

NUCC Taxonomy Code: 103TH0004X

A psychologist who specializes in clinical health psychology that investigates and implements clinical services across diverse populations and settings to promote health and well-being and to prevent, treat, and manage illness and disability. Clinical health psychology sees health as the confluence of psychological, social, cultural, and biological factors and applies this understanding to professional activities including:<br/>* Research<br/>* Clinical service<br/>* Consulting with, educating, and supervising other health care providers and psychologists<br/>* Advising organizations, institutions, the public, and policymakers

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Minnesota Board of Medical Practice.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - CLINICAL PSYCHOLOGIST

Medicare Enrollment ID

I20161130000326

Enrollment State Jurisdiction

MN

PECOS Control ID

0941472153

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

22 listed
Prince Aloh

Nurse Practitioner - Family

NPI 1194439935
Dr. Eftu Boru , MD

Family Medicine

NPI 1174055131

Doctor of Medicine (M.D.)

Elizabeth Coyne

Nurse Practitioner - Family

NPI 1750046256
Dr. Lea Ekochin , MD

Internal Medicine

NPI 1740424928

Doctor of Medicine (M.D.)

Erin Erickson , APRN, CNP

Nurse Practitioner - Family

NPI 1386180875

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Dr. Byron Holth , MD

Family Medicine

NPI 1184680464

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

11 Historical Events
βœ…
NPI Profile Active May 18, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location May 18, 2017

Registered at 11269 JEFFERSON HWY N, CHAMPLIN, MN 553163123 (Tel: 7632360600)

πŸ“
Updated Business Mailing Address May 18, 2017

Registered at 401 14TH AVE SE, PUYALLUP, WA 98372 (Tel: (253) 697-2700)

πŸ‘€
Provider Name / Credentials Updated May 18, 2017

Recorded as MARK GOETZ, PHD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 18, 2017

Psychologist

βœ…
NPI Profile Active September 22, 2011

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 22, 2011

Registered at 401 14TH AVE SE, PUYALLUP, WA 983723770 (Tel: 2536972700)

πŸ“
Business Mailing Address (Initial Record) September 22, 2011

Registered at 401 14TH AVE SE, PUYALLUP, WA 98372 (Tel: 2536972700)

πŸ‘€
Provider Name / Credentials (Initial Record) September 22, 2011

Recorded as MARK GOETZ, PHD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 22, 2011

Psychologist

🟒
Initial NPI Registration & Enumeration June 03, 2011

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1780978023
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 03, 2011
Last Update: April 09, 2021
Sole Proprietor: No

Mailing Address

401 14th Ave Se

Puyallup, WA 98372

Phone: 2536972700

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.