Active NPI
Daren J Wickum, M.D.
- Orthopaedic Surgery Physician
- Vadnais Heights, MN
National Provider Identifier
1073587606
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 44501
- Practice address
- 3580 Arcade St
Vadnais Heights, MN 55127-7135 - Phone
- (651) 968-5770
- Fax
- (651) 968-5775
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 44501 | MN | Primary |
Addresses
Primary practice location
3580 Arcade St
Vadnais Heights, MN 55127-7135
Mailing address
710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5042
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 427973500 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- University of Minnesota Medical School, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
319 S Main St
River Falls, WI 54022-2452
Phone (651) 968-5201
3580 Arcade St
Vadnais Heights, MN 55127-7135
Phone (651) 968-5201
Hospital & facility affiliations
- M Health Fairview Woodwinds Hospital
- River Falls Area Hospital
- Allina United Hospital
- Abbott Northwestern Hospital
- M Health Fairview University of MN Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.85 of 100
- Quality
- 92.29
- Promoting interoperability
- 94
- Improvement activities
- 40
- Cost
- 92.22
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hip replacement | 32 |
| Knee replacement | 31 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20643 | WI | MD | Endocrinology, Diabetes & Metabolism Physician |
| 44501 | MN | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Orthopedics, LTD | Orthopaedic Surgery | Current | Accepting new patients |
| Summit Orthopedics LTD | Current | Accepting new patients | |
| Ilbnc, P.a. | Past | Accepting new patients |
Locations
1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300
2620 Eagan Woods Dr
Saint Paul, MN 55121
Phone (651) 968-5142
3580 Arcade St
Vadnais Heights, MN 55127
Phone (651) 968-5600
710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042
2090 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 968-5801
319 S Main St
River Falls, WI 54022
Phone (715) 425-6701
Interoperability endpoints
- darenjwickum@sol.allscriptsdirect.net
Organizations & group practices 3
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.
-
- Clinic/Center
- Woodbury, MN
- NPI 1558870196
-
- Orthopaedic Surgery of the Spine Physician
- Bloomington, MN
- NPI 1023001815
Hospital & facility affiliations 43
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- St Paul, MN
- NPI 1265474704
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435795200000",
"number": "1073587606",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 COMMERCE DR STE 200",
"city": "WOODBURY",
"state": "MN",
"postal_code": "551254925",
"telephone_number": "651-968-5042",
"fax_number": "651-968-5904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3580 ARCADE ST",
"city": "VADNAIS HEIGHTS",
"state": "MN",
"postal_code": "551277135",
"telephone_number": "651-968-5770",
"fax_number": "651-968-5775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKUM",
"first_name": "DAREN",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2015-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MN",
"license": "44501",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "427973500",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vadnais Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.