Individual provider Active NPI

Melanie Sue Putman, AUD

  • Audiologist
  • Apple Valley, MN
National Provider Identifier
1831934066
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
528935 Issued in MN
Practice address
14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone
(651) 241-3779
Fax
(651) 241-3831
NPI assigned
Jun 28, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 528935 MN Primary

Addresses

Primary practice location

14655 Galaxie Ave
Apple Valley, MN 55124-8602

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726002097 MN Practitioner - Qualified Audiologist 4880130715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone (651) 241-3779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
528935MNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Aug 5, 2024 Accepting new patients
Allina Health System CurrentSince Aug 5, 2024 Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

1021 Bandana Blvd E
Ste 100
Saint Paul, MN 55108
Phone (877) 414-2533

Interoperability endpoints

  • Direct secure messaging: mputman663096@excellian.direct.allina.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1831934066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14655 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248602",
            "telephone_number": "651-241-3779",
            "fax_number": "651-241-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTMAN",
        "first_name": "MELANIE",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "528935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.