John J Nicotra, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

42549 Issued in MN

Practice address

2525 Chicago Ave
Minneapolis, MN 55404-4518

Phone

(612) 813-8200

NPI assigned

Jun 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

State University of New York Downstate Medical Center, 1990

Medicare assignment

May accept Medicare assignment

Group practices

Children'S Health CareGroup PAC ID 2668370966, 76 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Childrens Health Care

  • Pediatrics Physician
  • Minneapolis, MN
  • NPI 1932208808
  Medicare reassignment Care Compare group NPD
• Children'S Health Care

  • Radiology Clinic/Center
  • Minneapolis, MN
  • NPI 1093994030
  NPD
• Childrens Health Care

  • Children's Hospital
  • Minneapolis, MN
  • NPI 1881793750
  NPD
• Childrens Health Care Services Inc

  • Radiology Clinic/Center
  • Minnetonka, MN
  • NPI 1528167491
  NPD
• Diagnostic Imaging Associates, P.C.

  • Diagnostic Radiology Physician
  • Des Moines, IA
  • NPI 1528030194
  NPD (past)

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1194753335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 46100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554460100",
            "telephone_number": "763-553-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044518",
            "telephone_number": "612-813-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOTRA",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "MN",
            "license": "42549",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "42549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicollet Pharmacy LLC
• Nicollet Pharmacy LLC
• Nicollet Senior Center Inc
• Nicollet Vision Care Optometrists P.a.
• Nicollet Vision Care Optometrists P.a.
• Yingjiu Nie, M.A.
• Ann Niebuhr, MA
• Lindsey Niederhaus, PHARMD
• Abigail Kathleen Niedorf
• Gloria Elizabeth Niehans, M.D.

• Diagnostic Radiology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.

Verify at the official NPI Registry.