Alaa Sakallah

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP7069 Issued in MN

Practice address

3833 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2643

Phone

(763) 427-8320

NPI assigned

Jul 3, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Minneapolis Clinic of Neurology, LTD

  • Neurology Physician
  • Golden Valley, MN
  • NPI 1992739247

  Clinical Neuropsychologist

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1104662691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 COON RAPIDS BLVD NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332697",
            "telephone_number": "763-427-8320",
            "fax_number": "763-302-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332643",
            "telephone_number": "763-427-8320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4225 Golden Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554224215",
            "country_code": "US",
            "telephone_number": "763-588-0661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAKALLAH",
        "first_name": "ALAA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP7069",
            "primary": true
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MN",
            "license": "LP7069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aj Ryti
• Inga Inna Saburov, MA/ CCC-A
• Michelle Saenz, DPT
• George Owusu Safo, RN
• Raghuwansh P Sah, MBBS
• Saldano Transportation
• Nicole Renee Salfer, PT
• Natalia Angeles Samson-Bucu, MD
• Shamera Samuel
• Ella Pearl Sanchez

• Clinical Psychologist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.