Individual provider Active NPI

Anne Gallatin Nelesen, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Saint Paul, MN
National Provider Identifier
1326166588
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7072 Issued in MN
Practice address
1216 Selby Avenue
Saint Paul, MN 55104
Phone
(651) 698-1729
Fax
(855) 611-8594
NPI assigned
Mar 27, 2007
Last updated
May 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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 7072 MN Primary

Addresses

Primary practice location

1216 Selby Avenue
Saint Paul, MN 55104

Mailing address

1216 Selby Avenue
Saint Paul, MN 55104
Phone (651) 698-1729

Other names 1

  • Anne Lenore Gallatin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170414000530 MN Practitioner - Qualified Speech Language Pathologist 8729364336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
University of Wisconsin School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1216 Selby Ave
Saint Paul, MN 55104-6421
Phone 65169817291010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7072MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Speech, Language, and Learning, Inc. PastSince Apr 5, 2017 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1326166588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 SELBY AVENUE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-698-1729",
            "fax_number": "855-611-8594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 SELBY AVENUE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-698-1729",
            "fax_number": "855-611-8594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELESEN",
        "first_name": "ANNE",
        "middle_name": "GALLATIN",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "7072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "GALLATIN",
            "middle_name": "LENORE",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 May 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.