Individual provider Active NPI

Katherine Desprez Wick, MD

  • Hospitalist Physician
  • Rochester, MN
National Provider Identifier
1003311929
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
73578 Issued in MN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Mar 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A164113 CA
Hospitalist Physician 208M00000X 73578 MN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

4150 V St
Ste 111
Sacramento, CA 95817
Phone (916) 734-2737

Other practice location 1

6815 Aqua Trl
Inver Grove Heights, MN 55077-6700
Phone (918) 607-9695

Other names 1

  • Katherine Elizabeth Desprez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230530003162 MN Practitioner - Hospitalist 3779911532 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A164113CAMDInternal Medicine Physician
73578MNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic CurrentSince May 15, 2023 Accepting new patients
Mayo Clinic CurrentSince May 15, 2023 Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1003311929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 V ST",
            "address_2": "STE 111",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6815 Aqua Trl",
            "address_purpose": "LOCATION",
            "city": "Inver Grove Heights",
            "state": "MN",
            "postal_code": "550776700",
            "country_code": "US",
            "telephone_number": "918-607-9695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WICK",
        "first_name": "KATHERINE",
        "middle_name": "DESPREZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-25",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A164113",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "73578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "DESPREZ",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.