DR. SAMUEL ROBERT ALEXANDER DC, LN
NPI 1134635485
Nutritionist in Roseville, MN
About Dr. Samuel Robert Alexander Dc, Ln NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. SAMUEL ROBERT ALEXANDER DC, LN (NPI 1134635485) is an individual nutritionist in Roseville, Minnesota, licensed in Minnesota (N257) and active in the NPI registry since December 2017. He is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Samuel Robert Alexander Dc, Ln is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Samuel Alexander reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Saint Paul, MN 55114
- Reassigned Medicare billing, Minnesota enrollment
- 17 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Samuel Alexander's NPI number?
The NPI number for Samuel Alexander is 1134635485. It was assigned to this individual provider in the NPPES registry on December 22, 2017.
Where is Samuel Alexander located?
Samuel Alexander practices at 1700 S Hwy 36 Service Dr #400, Roseville, MN 55113. The listed phone number is (507) 519-0552.
What is Samuel Alexander's specialty?
The primary specialty registered for this NPI is Nutritionist with taxonomy code 133N00000X.
Is Samuel Alexander enrolled in Medicare?
Yes. Samuel Alexander is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Samuel Alexander's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Samuel Alexander reassigns Medicare benefits to Susan Borden Psych (Saint Paul, MN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samuel Alexander's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Samuel Alexander was last updated on October 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Samuel Robert Alexander, DC, LN · NPI 1134635485
Nutritionist provider in Roseville, Minnesota. Individual provider, active in the CMS NPPES registry since December 22, 2017.
## Identity
- **NPI:** 1134635485 (Entity type: Individual)
- **Enumerated:** December 22, 2017
- **Primary specialty:** Nutritionist · taxonomy 133N00000X
- **State license:** N257 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1700 S HWY 36 SERVICE DR, #400, Roseville, MN 55113-2453
- **Phone:** (507) 519-0552
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Susan Borden Psych (NPI 1780313478, Saint Paul, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** October 15, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1134635485) · Data from the CMS NPPES public registry.