Active NPI
Bita Payesteh, SLP
- Speech-Language Pathologist
- Minneapolis, MN
National Provider Identifier
1306172168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 104671
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 104671 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Audiologist
- Minneapolis, MN
- NPI 1427243484
Speech-Language Pathologist
-
- Clinic Pharmacy
- Minneapolis, MN
- NPI 1528288875
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.