MS. LISA CAROL BECKSTROM (MA, CCC-SLP) – Speech-Language Pathologist, NPI 1417019035

MS. LISA CAROL BECKSTROM (MA, CCC-SLP) is a healthcare provider. based in St louis park, Minnesota. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold the professional credentials MA, CCC-SLP. They hold a License No. 5642 (MN). The NPI Number for MS. LISA CAROL BECKSTROM (MA, CCC-SLP) is 1417019035

Main info

Female
35 Years Of Experience
Accepts Medicare Assignment
Name
MS. LISA CAROL BECKSTROM (MA, CCC-SLP)
NPI
1417019035
Phone
(952) 993-5498
Address
6500 EXCELSIOR BLVD
Enumeration Date
14 December 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9529933123
Graduation Year
1991 (35 years ago)
PAC ID
7315087871
Group Practice PAC ID
7911819438
Professional Enrollment ID
I20091215000321
Address ID
MN554162527ST3850XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

239 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in MN

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Provider Addresses for MS. LISA CAROL BECKSTROM (MA, CCC-SLP)

  • Excelsior Boulevard, Minikahda Vista, Saint Louis Park, Hennepin County, Minnesota, 55416:55424, United States

    REHAB SERVICES - SPEECH PATHOLOGY

    ST LOUIS PARK, MN 554264702

    Phone: (952) 993-5498

    Fax: (952) 993-5585

    Type: Location

  • 5641, Adair Avenue North, Crystal, Hennepin County, Minnesota, 55429, United States

    CRYSTAL, MN 554292706

    Phone: (952) 993-5498

    Fax: (952) 993-5585

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-12-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20091215000321IQualified Speech Language PathologistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92611Evaluation of swallowing function image1616$0
View full utilization report →

Insurance plans in this area (ZIP 55426)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911819438View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
Family PracticeMN
-MN
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMN
Cardiac ElectrophysiologyMN
Family PracticeMN
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physician AssistantMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

What is the 10-digit NPI for MS. LISA CAROL BECKSTROM (MA, CCC-SLP)?
MS. LISA CAROL BECKSTROM (MA, CCC-SLP) — NPI 1417019035 — is the standard way to identify this listing.
Is MS. LISA CAROL BECKSTROM (MA, CCC-SLP) listed as active for patients and plans?
The listing shows MS. LISA CAROL BECKSTROM (MA, CCC-SLP) as active in the NPI system.
What is MS. LISA CAROL BECKSTROM (MA, CCC-SLP)'s specialty?
The listing groups MS. LISA CAROL BECKSTROM (MA, CCC-SLP) with Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
What area does MS. LISA CAROL BECKSTROM (MA, CCC-SLP) serve?
MS. LISA CAROL BECKSTROM (MA, CCC-SLP)'s listing highlights St Louis Park, Minnesota; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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