Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Mark Dominic Bertucci, PSYD, LP

Individual provider Clinical Psychologist · NPI 1376055665

Dr. Mark Dominic Bertucci, PSYD, LP is a Clinical Psychologist in Burnsville, Minnesota. Qualified in 2016, 10 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
10
Licensed in
MN
In the registry since
2017
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

675 E Nicollet Blvd Ste 250
Burnsville, MN 55337-6768
Phone: (952) 993-3307
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1910 Hennepin Ave, Minneapolis, MN 55403-3160 — (612) 871-2544
  • 6 E Diamond Lake Rd, Minneapolis, MN 55419-1923 — (612) 568-6077

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence LP6174 (MN)

Record details

NPI number1376055665
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD , LP
Sole proprietorNo
NPI enumeratedOctober 26, 2017
Last updated in NPPESMarch 17, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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