Individual provider Active NPI

Jennifer Emily Dick, MD

  • Dermatology Physician
  • Edina, MN
National Provider Identifier
1508805631
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
47184 Issued in MN
Practice address
3316 W 66TH St
Suite 200
Edina, MN 55435-2506
Phone
(952) 920-3808
Fax
(952) 920-8899
NPI assigned
Jun 5, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 47184 MN Primary

Addresses

Primary practice location

3316 W 66TH St
Suite 200
Edina, MN 55435-2506

Mailing address

2929 Drew Ave S
Minneapolis, MN 55416-4210
Phone (612) 239-6882

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060728000328 MN Practitioner - Dermatology 4486667938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Minnesota Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Specialists, PAGroup PAC ID 1456248137, 18 clinicians

Practice addresses (Care Compare)

3316 W 66TH St
Edina, MN 55435-2532

3316 W 66TH St
Edina, MN 55435-2544
Phone (952) 920-3808

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.35 of 100Reported as group
Quality
58.09
Improvement activities
40
Cost
87.03

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14
Removal of skin lesions620
Removal or shaving of skin growth38
Skin biopsy152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47184MNMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Specialists, PA Dermatology CurrentSince Sep 1, 2006 Accepting new patients

Locations

3316 W 66th St
Edina, MN 55435
Phone (952) 920-3808

3316 W 66th St
Ste 200
Minneapolis, MN 55435
Phone (612) 920-3808

Interoperability endpoints

  • Direct secure messaging: jdick@directaddress.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1508805631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 DREW AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164210",
            "telephone_number": "612-239-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 W 66TH ST",
            "address_2": "SUITE 200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352506",
            "telephone_number": "952-920-3808",
            "fax_number": "952-920-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICK",
        "first_name": "JENNIFER",
        "middle_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MN",
            "license": "47184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.