Individual provider Active NPI

Nicole D Silloway, PA-C

  • Physician Assistant
  • Maplewood, MN
National Provider Identifier
1386636553
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2165 White Bear Ave N
Maplewood, MN 55109-2707
Phone
(651) 523-9800
NPI assigned
Aug 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Physician Assistant 363A00000X 9401 MN
Medical Physician Assistant 363AM0700X 9401 MN
Medical Physician Assistant 363AM0700X 1954 WI

Addresses

Primary practice location

2165 White Bear Ave N
Maplewood, MN 55109-2707

Mailing address

7200 Valley Creek Plaza
Woodbury, MN 55125-2265

Other practice location 1

7200 valley creek plaza
woodbury, MN 55125-2265
Phone (651) 735-7083

Other identifiers 3

IdentifierTypeStateIssuer
42882500MedicaidWI
729430100MedicaidMN
003756125OtherWIMEDICARE #

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040902000816 MN Practitioner - Physician Assistant 3577538404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Minuteclinic Diagnostic of Minnesota PAGroup PAC ID 7810289949, 83 clinicians
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

1500 109TH Ave NE
Blaine, MN 55449-4670
Phone (866) 389-2727

205 Wabasha Ave S
Saint Paul, MN 55107-1805

6445 Richfield Pkwy
Richfield, MN 55423-6400
Phone (866) 389-2727

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

875 E Main St
Waconia, MN 55387-1081
Phone (866) 389-2727

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9401MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Sep 15, 2008 Accepting new patients
Group Health, Inc. CurrentSince Sep 15, 2008 Accepting new patients
Group Health, Inc. Past Accepting new patients

Locations

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

7373 France Ave S
Ste 202
Minneapolis, MN 55435
Phone (952) 835-1311

2165 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 523-9800

403 Stageline Rd
Hudson, WI 54016
Phone (715) 386-8880

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: nsilloway42818@direct.healthpartners.com

Organizations & group practices 4

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1386636553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 VALLEY CREEK PLAZA",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2165 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092707",
            "telephone_number": "651-523-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 valley creek plaza",
            "address_purpose": "LOCATION",
            "city": "woodbury",
            "state": "MN",
            "postal_code": "551252265",
            "country_code": "US",
            "telephone_number": "651-735-7083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SILLOWAY",
        "first_name": "NICOLE",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9401",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "9401",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1954",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42882500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "729430100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE #",
            "identifier": "003756125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

Verify at the official NPI Registry.