Individual provider Active NPI

Alyssa Ann Leese, CNP

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1285187658
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP4763 Issued in MN
Practice address
178 9TH St E Ste 300
Saint Paul, MN 55101-2577
Phone
(877) 440-1001
NPI assigned
Aug 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP4763 MN Primary

Addresses

Primary practice location

178 9TH St E Ste 300
Saint Paul, MN 55101-2577

Mailing address

178 9TH St E Ste 300
Saint Paul, MN 55101-2577
Phone (877) 440-1001

Other names 1

  • Alyssa Ann Lund Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170207001824 MN Practitioner - Nurse Practitioner 4688957160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

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

5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP4763MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtuwell Medical Services, P.C. Past Accepting new patients
Healthpartners, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1285187658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 9TH ST E STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012577",
            "telephone_number": "877-440-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 9TH ST E STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012577",
            "telephone_number": "877-440-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEESE",
        "first_name": "ALYSSA",
        "middle_name": "ANN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2022-03-07",
        "certification_date": "2022-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP4763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "LUND",
            "middle_name": "ANN",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.