Jacky Ann Dickman, MD
Individual provider Active NPI Surgery Physician · Rochester, MN
NPI 1285437954 · NPPES record last updated Jul 27, 2026
Key facts
- NPI
- 1285437954
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 83022 (MN)
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Mar 28, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- University of Wisconsin School of Medicine, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Minneapolis, MN 55486
PO Box
860912 Provider Enrollment RST
Minneapolis, MN 55486-0912
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250811001375 | MN | Order and Referring Only - General Surgery |
4587162490 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35160 | MN | MD | Psychiatry Physician |
Interoperability endpoints
- jdickman355697@ehrdirect.mayoclinicmsg.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 83022 | MN | Yes |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
PO Box 860912
Minneapolis, MN 55486-0912
Phone (507) 284-2511
Other practice location 1
1000 1st Dr NW
Austin, MN 55912-2941
Phone (507) 433-7351
Other practice location 2
800 West Ave S
LA Crosse, WI 54601-8806
Phone (608) 785-0940
Other practice location 3
1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-1811
Other practice location 4
1400 Bellinger St
Eau Claire, WI 54703-5222
Phone (715) 838-5222
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jdickman355697@ehrdirect.mayoclinicmsg.org |
Other providers in Rochester, MN
- Kelly Johanna Dicke
- Erin Dickerhoof
- Alison Dickinson
- Jake Joseph Dickinson
- Karen Dickinson
- Madison Rae Dickovich
- Nicholas John Dickovich
- Sarah J Diedrich (Waldo)
- Daniel A Diedrich
- Felix E Diehn
All providers in Rochester, MN · Surgery Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.