Jill Marie Wilcken
Individual provider Active NPI Family Nurse Practitioner · Melrose, MN
NPI 1306456256 · NPPES record last updated Aug 5, 2020
Key facts
- NPI
- 1306456256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 7600 (MN)
- Practice address
- 525 Main St W
Melrose, MN 56352-1043 - Phone
- (320) 256-4228
- NPI assigned
- Aug 5, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Centracare Health System - Melrose
Practice addresses (Care Compare)
525 Main St W
Melrose, MN 56352-1043
Phone (320) 256-4231
Hospital & facility affiliations
- Centracare Health System - Melrose Hospital
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201013002546 | MN | Practitioner - Nurse Practitioner | 4082034004 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7600 | MN | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Cloud Hospital | Current | Accepting new patients | |
| Centracare Health System - Melrose | Current |
Accepting new patients | |
| St. Cloud Hospital | Current |
Accepting new patients | |
| Centracare Clinic | Current |
Accepting new patients | |
| Matrix Medical Plus | Current |
Accepting new patients | |
| Centracare Clinic | Current |
Accepting new patients | |
| Centracare Health System - Melrose | Current |
Accepting new patients | |
| St. Cloud Hospital | Current |
Accepting new patients | |
| St. Cloud Hospital | Past | Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
525 Main St W
Melrose, MN 56352
Phone (320) 256-4228
121 Washington Ave N
Fl 4
Minneapolis, MN 55401
Phone (404) 992-2702
1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342
1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422
1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657
110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375
Interoperability endpoints
- jwilcken528574@direct.centracare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 7600 | MN | Yes |
Addresses
Primary practice location
525 Main St W
Melrose, MN 56352-1043
Mailing address
26122 80TH Ave
Saint Cloud, MN 56301-9836
Phone (320) 469-4771
Other providers in Melrose, MN
- Russell Roman Sieben
- Josie Lauren Stenger
- Elaine Mary Thelen
- Jennifer Rose Tomford
- Gerald Wensmann
- Sheila Wing
- Sarah Jane Zimmer
- Leann Marie Zimny
All providers in Melrose, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2020. 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.