Autumn Kallock, - Medicare Speech-Language Pathologist in East Grand Forks, MN

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Autumn Kallock, is a medicare enrolled "Speech-language Pathologist" provider in East Grand Forks, Minnesota. Her current practice location is 1420 4th Ave Nw, East Grand Forks, Minnesota. You can reach out to her office (for appointments etc.) via phone at (218) 773-3494.

Autumn Kallock is licensed to practice in North Dakota (license number 2656) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1538905427.

Contact Information

Autumn Kallock,
1420 4th Ave Nw,
East Grand Forks, MN 56721-1522
(218) 773-3494
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameAutumn Kallock
GenderFemale
SpecialitySpeech-language Pathologist
Location1420 4th Ave Nw, East Grand Forks, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1538905427
  • Provider Enumeration Date: 07/01/2024
  • Last Update Date: 04/14/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 0749799666
  • Enrollment ID: I20250603000817

Medical Identifiers

Medical identifiers for Autumn Kallock such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1538905427NPI-NPPES
2656OtherNDSTATE SLP LICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
235Z00000XSpeech-language Pathologist 2656 (North Dakota)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Autumn Kallock allows following entities to bill medicare on her behalf.
Provider NameLittle Miracles Inc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1821110982
PECOS PAC ID: 0749572543
Enrollment ID: O20160719000977

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Autumn Kallock is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Autumn Kallock,
2951 S 34th St,
Grand Forks, ND 58201-6061

Ph: (701) 772-3851		Autumn Kallock,
1420 4th Ave Nw,
East Grand Forks, MN 56721-1522

Ph: (218) 773-3494

Reviews and Comments


Speech-Language Pathologist in East Grand Forks, MN

Ms. Melanie Mae Nelson, SLP
Speech-Language Pathologist
Medicare: Not Enrolled in Medicare
Practice Location: 1420 4th Ave Nw, East Grand Forks, MN 56721
Phone: 218-773-3494    
Morgan Pieper-george, M.S. CCC-SLP
Speech-Language Pathologist
Medicare: Not Enrolled in Medicare
Practice Location: 1420 4th Ave Nw, East Grand Forks, MN 56721
Phone: 218-773-3494    
Cathy A Galstad, MS CCC/SLP
Speech-Language Pathologist
Medicare: Not Enrolled in Medicare
Practice Location: 1420 4th Ave Nw, East Grand Forks, MN 56721
Phone: 218-773-3494    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.