Individual provider Active NPI

Leslie A Clayton, PA C

  • Physician Assistant
  • Golden Valley, MN
National Provider Identifier
1619942323
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10024 Issued in MN
Practice address
8301 Golden Valley Rd Ste 100
Golden Valley, MN 55427-4469
Phone
(763) 581-5150
NPI assigned
Feb 17, 2006
Last updated
Aug 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10024 MN Primary

Addresses

Primary practice location

8301 Golden Valley Rd Ste 100
Golden Valley, MN 55427-4469

Mailing address

8100 34TH Ave S
21110Q
Bloomington, MN 55425-1672
Phone (952) 883-5790

Other identifiers 1

IdentifierTypeStateIssuer
779482700MedicaidMN

Other names 1

  • Leslie C Milteer 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
I20050728000701 MN Practitioner - Physician Assistant 0840228169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

10000 Zane Ave N
Brooklyn Park, MN 55443-1400
Phone (763) 528-6999

1440 Duckwood Dr
Eagan, MN 55122-1451
Phone (651) 406-8860

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (952) 914-1732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10024MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Clinics CurrentSince Feb 1, 2023 Accepting new patients
Fairview Clinics CurrentSince Feb 1, 2023 Accepting new patients
Healtheast Medical Research Institute CurrentSince Feb 1, 2023 Accepting new patients
Healtheast Medical Research Institute CurrentSince Feb 1, 2023 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients
Fairview Clinics Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

2945 Hazelwood St
Ste 100
Saint Paul, MN 55109
Phone (651) 232-7800

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

Interoperability endpoints

  • Direct secure messaging: lclayton744358@fairview.direct-ci.com

Organizations & group practices 8

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1619942323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 34TH AVE S",
            "address_2": "21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251672",
            "telephone_number": "952-883-5790",
            "fax_number": "952-883-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 GOLDEN VALLEY RD STE 100",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274469",
            "telephone_number": "763-581-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAYTON",
        "first_name": "LESLIE",
        "middle_name": "A",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "779482700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "MILTEER",
            "middle_name": "C",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.