Active NPI
Leslie Anunciacion, PA-C
- Physician Assistant
- Prior Lake, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12208
- Practice address
- 4670 Park Nicollet Ave SE
Prior Lake, MN 55372-4119 - Phone
- (952) 993-4999
- NPI assigned
- Sep 14, 2016
- Last updated
- Jan 9, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12208 | MN | Primary |
Addresses
Primary practice location
4670 Park Nicollet Ave SE
Prior Lake, MN 55372-4119
Mailing address
8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516
Other practice location 1
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-5200
Other practice location 2
205 Wabasha St S
Saint Paul, MN 55107-1805
Phone (952) 967-5584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
205 Wabasha Ave S
Saint Paul, MN 55107-1805
3800 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123
3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123
4670 Park Nicollet Ave SE
Prior Lake, MN 55372-4119
Phone (952) 993-7750
5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400
6000 Earle Brown Dr
Brooklyn Center, MN 55430-2506
Phone (952) 993-4900
8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Nicollet Clinic | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Past | Accepting new patients |
Locations
1654 Diffley Rd
Ste 100
Eagan, MN 55122
Phone (651) 456-8670
5625 Cenex Dr
Inver Grove Heights, MN 55077
Phone (651) 552-2600
9855 Hospital Dr
Ste 102A
Maple Grove, MN 55369
Phone (763) 581-9220
9855 Hospital Dr
Ste 104
Maple Grove, MN 55369
Phone (763) 581-5900
2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600
4730 Chicago Ave
Minneapolis, MN 55407
Phone (612) 313-0000
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
4670 Park Nicollet Ave SE
Prior Lake, MN 55372
Phone (952) 993-7750
3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048
1885 Plaza Dr
Saint Paul, MN 55122
Phone (952) 993-4001
205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100
2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200
451 Dunlap St N
Saint Paul, MN 55104
Phone (651) 647-2100
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba HealthPartners Medical Group
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1780621904
-
dba HealthPartners Riverside Dental Clinic
- Pediatric Dentistry
- Minneapolis, MN
- NPI 1700932449
-
dba HealthPartners Midway Residency Dental
- General Practice Dentistry
- Saint Paul, MN
- NPI 1952042053
-
- Family Medicine Physician
- St Louis Park, MN
- NPI 1063897593
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Maple Grove, MN
- NPI 1174980692
-
dba Park Nicollet Methodist Hospital Outpatient Surgery Center
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1194113217
-
dba PN Methodist Hospital Episodic Bundle
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1245615772
-
dba Park Nicollet Melrose Center
- Mental Illness Community Based Residential Treatment Facility
- St Louis Park, MN
- NPI 1578717336
Hospital
-
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1649220724
-
dba Park Nicollet Melrose Center
- General Acute Care Hospital
- St Louis Park, MN
- NPI 1942585286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736380800000",
"number": "1124576590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S # MS 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4670 PARK NICOLLET AVE SE",
"city": "PRIOR LAKE",
"state": "MN",
"postal_code": "553724119",
"telephone_number": "952-993-4999"
}
],
"practiceLocations": [
{
"address_1": "3300 Oakdale Ave N",
"address_purpose": "LOCATION",
"city": "Robbinsdale",
"state": "MN",
"postal_code": "554222926",
"country_code": "US",
"telephone_number": "763-520-5200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "205 Wabasha St S",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551071805",
"country_code": "US",
"telephone_number": "952-967-5584",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANUNCIACION",
"first_name": "LESLIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-14",
"last_updated": "2025-01-09",
"certification_date": "2025-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "12208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Prior Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.