Individual provider Active NPI

Melissa Rosewall Polski, MSW, LICSW

  • Clinical Social Worker
  • St Louis Park, MN
National Provider Identifier
1851106207
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
30162 Issued in MN
Practice address
5775 Wayzata Blvd Ste 255
St Louis Park, MN 55416-1275
Phone
(952) 525-4500
NPI assigned
Feb 12, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 30162 MN Primary

Addresses

Primary practice location

5775 Wayzata Blvd Ste 255
St Louis Park, MN 55416-1275

Mailing address

5775 Wayzata Blvd Ste 255
St Louis Park, MN 55416-1275
Phone (952) 525-4500

Other names 1

  • Melissa Jean Rosewall Professional 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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250226000036 MN Practitioner - Clinical Social Worker 6901326545 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

5775 Wayzata Blvd
Suite 255
Minneapolis, MN 55416-1275
Phone (952) 525-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30162MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 24, 2025 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Health Services CurrentSince Apr 21, 2025 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 24, 2025 Accepting new patients
Fairview Express Care CurrentSince Jan 24, 2025 Accepting new patients
University of Minnesota Physicians CurrentSince Jan 24, 2025 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 24, 2025 Accepting new patients
Fairview Health Services CurrentSince Apr 21, 2025 Accepting new patients
Fairview Health Services Current Accepting new patients

Locations

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

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

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

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

5775 Wayzata Blvd
Ste 255
St Louis Park, MN 55416
Phone (612) 273-8710

Organizations & group practices 11

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": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1851106207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 255",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161275",
            "telephone_number": "952-525-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 WAYZATA BLVD STE 255",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161275",
            "telephone_number": "952-525-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSKI",
        "first_name": "MELISSA",
        "middle_name": "ROSEWALL",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "30162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "ROSEWALL",
            "middle_name": "JEAN",
            "credential": "MSW, LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.