Samantha Rose Callisto, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10070 Issued in MN

Practice address

420 Delaware St SE
Mayo B455/MMC 106
Minneapolis, MN 55455-0341

Phone

(612) 273-6351

NPI assigned

Jun 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD (past)

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637452800000",
    "number": "1679954929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14500 99TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694730",
            "telephone_number": "763-898-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MAYO B455/MMC 106",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341",
            "telephone_number": "612-273-6351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLISTO",
        "first_name": "SAMANTHA",
        "middle_name": "ROSE",
        "name_prefix": "Miss",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2021-11-21",
        "certification_date": "2021-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samantha.callisto@fairview.org",
            "affiliation": "Y",
            "endpointDescription": "email address",
            "affiliationName": "FAIRVIEW HEALTH SERVICES",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "420 Delaware St SE",
            "address_2": "Mayo B455/MMC 106",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554550341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Krysten Callahan
• Angela Callais, LICSW
• Abigail Callaway
• Matthew Clayton Callier, MD
• Lisa S Callies, MD
• Calm-Clinic for Attention, Learning, and Memor
• Calmcare Psychiatry Clinic S.C.
• Ashley Marie Calore, AGNP-BC
• Stephen Eugene Calvit, LICSW
• Darryl Victor Calvo, M.D.

• Physical Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2021; 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.