Active NPI
Leakaynah Lin Shaleen, PA-C
- Physician Assistant
- Anoka, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 11240
- Practice address
- 601 Jacob LN
Anoka, MN 55303-1776 - Phone
- (763) 587-4200
- NPI assigned
- May 16, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11240 | MN | Primary |
Addresses
Primary practice location
601 Jacob LN
Anoka, MN 55303-1776
Mailing address
PO Box 1309
Ms 21110Q
Minneapolis, MN 55440-1309
Phone (651) 254-3456
Other practice location 1
640 Jackson St
Saint Paul, MN 55101-2502
Phone (651) 254-3456
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400
435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848
8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11240 | MN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Health, Inc. | Current | Accepting new patients |
Locations
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164
401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7870
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.
-
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
-
- Family Medicine Physician
- Stillwater, MN
- NPI 1578932943
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582588800000",
"number": "1821358458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1309",
"address_2": "MS 21110Q",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554401309",
"telephone_number": "651-254-3456",
"fax_number": "651-254-9673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 JACOB LN",
"city": "ANOKA",
"state": "MN",
"postal_code": "553031776",
"telephone_number": "763-587-4200"
}
],
"practiceLocations": [
{
"address_1": "640 Jackson St",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551012502",
"country_code": "US",
"telephone_number": "651-254-3456",
"fax_number": "651-254-9673",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHALEEN",
"first_name": "LEAKAYNAH",
"middle_name": "LIN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-16",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "11240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Anoka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.