Johnathan Cicchese, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10069 Issued in MN

Practice address

1747 Beam Ave
Suite Number 100
Maplewood, MN 55109-1128

Phone

(651) 326-5569

NPI assigned

Aug 28, 2015

Last updated

Aug 28, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.63 of 100Reported as group

Quality

75.41

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment Care Compare group NPD
• Healtheast Outpatient Services, LLC

  • Physical Therapist
  • Saint Paul, MN
  • NPI 1225382526
  Medicare reassignment NPD
• Fairview Express Care

  • Eyewear Supplier
  • Eagan, MN
  • NPI 1811448210
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Healtheast Medical Research Institute

  dba HealthEast Grand Avenue Clinic

  • Clinic/Center
  • Saint Paul, MN
  • NPI 1730128398
  NPD (past)

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1073980793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 HENRY ST N",
            "city": "NORTH SAINT PAUL",
            "state": "MN",
            "postal_code": "551094114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 BEAM AVE",
            "address_2": "SUITE NUMBER 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091128",
            "telephone_number": "651-326-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCHESE",
        "first_name": "JOHNATHAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CHP Maplewood MN Tenant Corp.
• Trenton Allen Christensen, PA-C
• Kristen Marie Chuba, PA-C
• Christine Knecht Church, PH.D. LP
• Margaret Phelps Chute, MD
• City of Maplewood
• Carol Jones Clark, MS CCC SLP
• Lindsey Alice Clark, PTA
• Mary Martha Clark, OTR-L
• Sean Hoban Clark

• Physical Therapist in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.