Individual provider Active NPI

Lamin Jaiteh

  • Family Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1619329133
Registry record updated Oct 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP 4615 Issued in MN
Practice address
625 Snelling Ave N Ste a
Saint Paul, MN 55104-5585
Phone
(513) 633-1111
NPI assigned
Jul 8, 2016
Last updated
Oct 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP 4615 MN Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4615 MN

Addresses

Primary practice location

625 Snelling Ave N Ste a
Saint Paul, MN 55104-5585

Mailing address

625 Snelling Ave N Ste a
Saint Paul, MN 55104-5585
Phone (651) 363-3111

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
I20161028001120 MN Practitioner - Nurse Practitioner 1759669500 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
Telehealth
Offers telehealth services
Group practices
Amazing HealthGroup PAC ID 0941687586, 3 clinicians

Practice addresses (Care Compare)

625 Snelling Ave N
Suite a 2
Saint Paul, MN 55104-2878
Phone (763) 381-4188

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP 4615MNMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633737600000",
    "number": "1619329133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SNELLING AVE N STE A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045585",
            "telephone_number": "651-363-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 SNELLING AVE N STE A",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045585",
            "telephone_number": "513-633-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAITEH",
        "first_name": "LAMIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2021-10-09",
        "certification_date": "2021-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "CNP 4615",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "4615",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.