JEREMY WILLIAM RONDORF PSY.D. NPI 1639227135

NPI Information

  • NPI: 1639227135
  • Provider Name: JEREMY WILLIAM RONDORF, PSY.D.
  • Classification: Psychologist - 103TA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 15245 PLEASANT VALLEY RD
    CENTER CITY, MN
    ZIP 55012
  • Phone: (651) 213-4184

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NPI Details

Jeremy William Rondorf, PSY.D. is an addiction (substance use disorder) psychologist in Center City, MN with 21 years of experience. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. Jeremy William Rondorf, PSY.D. NPI is 1639227135. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

15245 PLEASANT VALLEY RD
CENTER CITY, MN
ZIP 55012-640
Phone: (651) 213-4184
Fax: (651) 213-4411

The NPI 1639227135 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychotherapy, 45 minutes (HCPCS:90834)

The enumeration date for this NPI number is 1/8/2007 and was last updated on 3/11/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TA0400XPsychologistAddiction (Substance Use Disorder)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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