JACQUELYN AUSTIN (MA CCC-SLP) – Speech-Language Pathologist, NPI 1619386679

JACQUELYN AUSTIN (MA CCC-SLP) is a healthcare provider. based in Isanti, Minnesota. specializing in Speech-Language Pathologist. They hold the professional credentials MA CCC-SLP. They hold a License No. 9331 (MN). The NPI Number for JACQUELYN AUSTIN (MA CCC-SLP) is 1619386679

Main info

Female
Sole Proprietor
Name
JACQUELYN AUSTIN (MA CCC-SLP)
NPI
1619386679
Phone
(763) 444-8700
Address
904 6TH AVENUE CT NE
Enumeration Date
4 August 2014
Last Update Date
31 July 2018
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for JACQUELYN AUSTIN (MA CCC-SLP)

  • 904 6TH AVENUE CT NE

    ISANTI, MN 550403208

    Phone: (763) 444-8700

    Mailing address matches the actual address.

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: 2018-06-07

PECOS data refreshed: 2026-06-15

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
I20180607001843IQualified 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

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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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55040)

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Reviews

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Frequently asked questions

What is the registry number for JACQUELYN AUSTIN (MA CCC-SLP)?
The registry entry for JACQUELYN AUSTIN (MA CCC-SLP) shows NPI 1619386679.
Is JACQUELYN AUSTIN (MA CCC-SLP) currently accepting referrals based on NPI status?
Registry metadata lists JACQUELYN AUSTIN (MA CCC-SLP) as active.
Which specialty label fits JACQUELYN AUSTIN (MA CCC-SLP)?
NPPES ties JACQUELYN AUSTIN (MA CCC-SLP) to Speech-Language Pathologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to JACQUELYN AUSTIN (MA CCC-SLP)?
JACQUELYN AUSTIN (MA CCC-SLP) shows a connection to Isanti, Minnesota in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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