Individual provider Active NPI

Bita Payesteh, SLP

  • Speech-Language Pathologist
  • Minneapolis, MN
National Provider Identifier
1306172168
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
104671 Issued in TX
Practice address
115 Shevlin Hall
164 Pillsbury Dr SE
Minneapolis, MN 55408
Phone
(612) 624-3322
NPI assigned
Oct 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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 104671 TX Primary

Addresses

Primary practice location

115 Shevlin Hall
164 Pillsbury Dr SE
Minneapolis, MN 55408

Mailing address

115 Shevlin Hall
164 Pillsbury Dr SE
Minneapolis, MN 55408

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104671TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Minnesota Past Accepting new patients
Regents of the University of Minnesota Speech-Language Pathologist Past Accepting new patients

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": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1306172168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 SHEVLIN HALL",
            "address_2": "164 PILLSBURY DR SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 SHEVLIN HALL",
            "address_2": "164 PILLSBURY DR SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55408",
            "telephone_number": "612-624-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYESTEH",
        "first_name": "BITA",
        "name_prefix": "Miss",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.