Individual provider Active NPI

Andrea Mattie Sarkauskas, MS CCC-SLP

  • Speech-Language Pathologist
  • Saint Paul, MN
National Provider Identifier
1245752708
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9864 Issued in MN
Practice address
5290 Edgewood Dr
Saint Paul, MN 55112-4906
Phone
(637) 280-3202
NPI assigned
Jul 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 9864 MN Primary

Addresses

Primary practice location

5290 Edgewood Dr
Saint Paul, MN 55112-4906

Mailing address

5290 Edgewood Dr
Saint Paul, MN 55112-4906
Phone (320) 905-5369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Speech and Language Specialists LLC Speech-Language Pathologist CurrentSince Sep 19, 2022 Accepting new patients
Associated Speech and Language Past Accepting new patients

Locations

2395 Ariel St N
#B
Saint Paul, MN 55109
Phone (651) 773-3208

561 7th St W
Saint Paul, MN 55102
Phone (651) 225-4558

Organizations & group practices 2

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": "1500163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1245752708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5290 EDGEWOOD DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551124906",
            "telephone_number": "320-905-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5290 EDGEWOOD DR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551124906",
            "telephone_number": "637-280-3202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARKAUSKAS",
        "first_name": "ANDREA",
        "middle_name": "MATTIE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-16",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.