Leslie Anunciacion, PA-C
Individual provider Active NPI Physician Assistant · Prior Lake, MN
NPI 1124576590 · NPPES record last updated Jan 9, 2025
Key facts
- NPI
- 1124576590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 12208 (MN)
- Practice address
- 4670 Park Nicollet Ave SE
Prior Lake, MN 55372-4119 - Phone
- (952) 993-4999
- NPI assigned
- Sep 14, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Group Health Inc
Park Nicollet Clinic
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
- Park Nicollet Methodist Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161020001584 | MN | Practitioner - Physician Assistant | 1850679176 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Health, Inc. | Current |
Accepting new patients | |
| Park Nicollet Clinic | 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
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
4730 Chicago Ave
Minneapolis, MN 55407
Phone (612) 313-0000
5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400
2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600
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
451 Dunlap St N
Saint Paul, MN 55104
Phone (651) 647-2100
205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100
2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200
1885 Plaza Dr
Saint Paul, MN 55122
Phone (952) 993-4001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12208 | MN | Yes |
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
Other providers in Prior Lake, MN
- Idil Ahmed Ahmed
- Aligned Lifestyle Inc
- Amazing Home Behavioral Health Inc
- Anchoring Services, LLC
- Christine Marie Anderson
- Debra Arterbury
- Samuel Asante-Buabeng
- Aspen Academy
- Attune Chiropractic and Natural Health, PLLC
- Michael C. Babcock
All providers in Prior Lake, MN · Physician Assistant in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.