Alyssa Michaletz

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

518179 Issued in MN

Practice address

401 Phalen Blvd
Saint Paul, MN 55130-5302

Phone

(651) 254-3200

Fax

(651) 254-7710

NPI assigned

Oct 26, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Alyssa Wild Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regions HospitalGroup PAC ID 3173436755, 215 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Regions Hospital

  • Emergency Medicine Physician
  • Saint Paul, MN
  • NPI 1154359917
  Medicare reassignment Care Compare group NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  Medicare reassignment NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1063897593
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • Brooklyn Park, MN
  • NPI 1447668678
  NPD
• Regions Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1104681105
  NPD
• Regions Hospital

  • Rehabilitation Clinic/Center
  • Saint Paul, MN
  • NPI 1134157092
  NPD

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1982116273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PHALEN BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551305302",
            "telephone_number": "651-254-3200",
            "fax_number": "651-254-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALETZ",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-26",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "518179",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "4494-154",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "WILD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael J Miller Consulting LLC
• Michael L. Maristuen D.C., P.a.
• Michael V. Desanctis, PHD, Abpp, Licensed Psychologist PLLC
• Abigail Rebekah Michael, RN, BSN, PHN
• Amanda Michaelson, PHARMD
• Benjamin Michalicek, OD
• Michael Gregory Michalik, MD
• Bryan S Michalowicz, DDS, MS
• James Michaud
• Lavonne L Michaud, MD

• Speech-Language Pathologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.