Clare Elizabeth Cicconi, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12881 Issued in MN

Practice address

640 Jackson St
Saint Paul, MN 55101-2502

Phone

(651) 254-3456

Fax

(651) 254-9673

NPI assigned

Jun 14, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of New England, College of Osteo Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ridgeview Medical CenterGroup PAC ID 9234041997, 407 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Ridgeview Medical Center

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429

  MN

  Medicare reassignment Care Compare group
• Minnesota Valley Health Center Inc

  • Critical Access Hospital
  • Le Sueur, MN
  • NPI 1730248907

  MN

  Medicare reassignment NPD
• Sibley Medical Center

  • Critical Access Hospital
  • Arlington, MN
  • NPI 1740240225

  MN

  Medicare reassignment NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683

  MN

  Medicare reassignment NPD (past)
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175

  MN

  Medicare reassignment
• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503

  MN

  Medicare reassignment
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904

  MN

  Medicare reassignment
• Fairview Health Services

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Group Health, Inc.

  • Pediatric Dentistry
  • Minneapolis, MN
  • NPI 1700932449
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Healtheast Medical Research Institute

  • Clinic/Center
  • Maplewood, MN
  • NPI 1164154316
  NPD

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

• Ridgeview Medical Center

  • General Acute Care Hospital
  • Waconia, MN
  • NPI 1275608457

  Hospital

  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1508205386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-9673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "144 State St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041013776",
            "country_code": "US",
            "telephone_number": "207-879-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CICCONI",
        "first_name": "CLARE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "12881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CHW Solutions LLC
• CHW Solutions LLC
• Anne Ciaschini Marmol, PHARMD, MPH
• Jane Cicchese, RN, LSN, PHN
• Brenda Kay Ciccone, OTR
• Heather R Cichanowski, MD
• Melissa Pearl Cimfl
• Gina M Cincinelli, PA
• Circle Care LLC
• City of Lakes Home Care LLC

• Physician Assistant in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.