Active NPI
Nicole Marie Jedlicka, DPM
- Foot & Ankle Surgery Podiatrist
- Dubuque, IA
National Provider Identifier
1295047512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 000835
- Practice address
- 1500 Delhi St
Suite 2200
Dubuque, IA 52001-6358 - Phone
- (563) 557-5930
- NPI assigned
- Jul 2, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 000835 | IA | Primary |
Addresses
Primary practice location
1500 Delhi St
Suite 2200
Dubuque, IA 52001-6358
Mailing address
1500 Delhi St
Suite 2200
Dubuque, IA 52001-6358
Phone (563) 557-5930
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295047512 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 Delhi St
Suite 2200
Dubuque, IA 52001-6359
Phone (563) 557-5930
1500 Delhi St
Suite 2200
Dubuque, IA 52001-6391
Hospital & facility affiliations
- Finley Hospital
- Midwest Medical Center
- Guttenberg Municipal Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.05 of 100
- Quality
- 72.1
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 102 |
| Removal of skin lesions | 11 |
| Removal of nail tissue | 1144 |
| Removal or shaving of skin growth | 541 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000835 | IA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Dubuque Podiatry, PC | Foot & Ankle Surgery | Past | Accepting new patients |
Interoperability endpoints
- njedlicka108324@direct.unitypoint.org
Ownership & related parties
All facility ownership & control disclosures 3
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| The Finley Hospital | Hospital | Corporate Director | Mar 26, 2020 |
| The Finley Hospital | Hospital | Corporate Director | Mar 26, 2020 |
| Unitypoint at Home-Dubuque | Home health agency | Corporate Director | Mar 26, 2020 |
Owned or controlled facilities with NPI records 3
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
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.
-
- General Acute Care Hospital
- Cedar Rapids, IA
- NPI 1083708226
-
- Foot & Ankle Surgery Podiatrist
- Dyersville, IA
- NPI 1316056278
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Guttenberg, IA
- NPI 1932139359
-
- General Acute Care Hospital
- Dubuque, IA
- NPI 1942392600
-
- Critical Access Hospital
- Galena, IL
- NPI 1952409765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395705600000",
"number": "1295047512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 DELHI ST",
"address_2": "SUITE 2200",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520016358",
"telephone_number": "563-557-5930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 DELHI ST",
"address_2": "SUITE 2200",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520016358",
"telephone_number": "563-557-5930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEDLICKA",
"first_name": "NICOLE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-02",
"last_updated": "2014-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IA",
"license": "000835",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1295047512",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.