Individual provider Active NPI

Layla Asamarai, PSYD.

  • Clinical Psychologist
  • Roseville, MN
National Provider Identifier
1205287885
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4892 Issued in MN
Practice address
1611 County Road B W Ste 218
Roseville, MN 55113-4053
Phone
(612) 877-0777
Fax
(651) 358-2996
NPI assigned
Jun 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4892 MN Primary

Addresses

Primary practice location

1611 County Road B W Ste 218
Roseville, MN 55113-4053

Mailing address

1611 County Road B W Ste 202
Roseville, MN 55113-4053
Phone (651) 300-1112

Other practice location 1

1611 County Road B W Ste 202
Roseville, MN 55113-4053
Phone (612) 877-0777

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161102000016 MN Practitioner - Clinical Psychologist 9032497672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luminous Mind IncGroup PAC ID 3678816402, 9 clinicians

Practice addresses (Care Compare)

1611 County Rd B W
Suite 202
Roseville, MN 55113-4053
Phone (651) 300-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4892MNMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminous Mind Inc Clinical CurrentSince Apr 24, 2019 Accepting new patients

Locations

1611 County Road B W
Ste 218
Roseville, MN 55113
Phone (612) 389-9191

1611 County Road B W
Ste 202
Saint Paul, MN 55113
Phone (651) 300-1112

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1466812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1205287885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W STE 202",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134053",
            "telephone_number": "651-300-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W STE 218",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134053",
            "telephone_number": "612-877-0777",
            "fax_number": "651-358-2996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 County Road B W Ste 202",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "MN",
            "postal_code": "551134053",
            "country_code": "US",
            "telephone_number": "612-877-0777",
            "fax_number": "651-358-2996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASAMARAI",
        "first_name": "LAYLA",
        "name_prefix": "Dr.",
        "credential": "PSYD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-25",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

Verify at the official NPI Registry.