Marc Nicoloff, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1600 Saint Johns Blvd
Suite 201
Maplewood, MN 55109-1183

Phone

(651) 747-8500

Fax

(651) 747-8501

NPI assigned

Feb 2, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Merit-based Incentive Payment System (MIPS)

Final score

85.6 of 100Reported as group

Quality

72.5

Promoting interoperability

100

Improvement activities

40

Cost

77.07

Medicare enrollment (NPD)

Enrolled

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.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment
• Allina Health System

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment
• Allina Health System

  • General Practice Physician
  • St Paul, MN
  • NPI 1053617795
  NPD
• Allina Health System

  • Neurological Surgery Physician
  • Minneapolis, MN
  • NPI 1144264540
  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1619115458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 SMITH AVE N",
            "address_2": "SUITE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022533",
            "telephone_number": "651-726-6200",
            "fax_number": "651-726-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SAINT JOHNS BLVD",
            "address_2": "SUITE 201",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091183",
            "telephone_number": "651-747-8500",
            "fax_number": "651-747-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICOLOFF",
        "first_name": "MARC",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-02",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnicoloff30884@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1600 Saint Johns Blvd",
            "address_2": "Suite 201",
            "city": "Maplewood",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551091183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Linh Le Mai Nguyen de Castro, DNP, ARNP, PMHNP-BC
• Cali Ha Nguyen, OD
• Calvin T Nguyen, D.C
• Linh Nguyen
• Rachel Kay Nichols, PA-C
• Ericka Michelle Niemann, OT
• Catherine Wanjiru Njogu, B.A., D.C.
• Patricia Ann Nord, RN
• Katherine J Norelius, CRNA
• Hanna Rose Norlen

• Physician Assistant in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.