Kelly Johanna Dicke, APRN, CNP
Individual provider Active NPI Nurse Practitioner · Rochester, MN
NPI 1629668462 · NPPES record last updated Jan 17, 2024
Key facts
- NPI
- 1629668462
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 7905 (MN)
- Practice address
- 2355 Hwy 36 W.
Ste. 100
Rochester, MN 55905-0001 - Phone
- (651) 292-2000
- NPI assigned
- Jan 26, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 25
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Midwest Radiology PA
Practice addresses (Care Compare)
2355 Hwy 36 W
Suite 100
Roseville, MN 55113-3905
Phone (651) 292-2000
Hospital & facility affiliations
- Regions Hospital
- M Health Fairview St John'S Hospital
- Allina United Hospital
- M Health Fairview Woodwinds Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.17 of 100
- Quality
- 95
- Improvement activities
- 40
- Cost
- 82.21
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 |
|---|---|---|---|---|
| I20210309000993 | MN | Practitioner - Nurse Practitioner | 9638585169 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7905 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current |
Accepting new patients | |
| Suburban Imaging, LLC | Current |
Accepting new patients | |
| Allina Health System | Current |
Accepting new patients | |
| Midwest Radiology, PA | Current |
Accepting new patients | |
| Allina Health System | Current |
Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Midwest Radiology Outpatient Imaging, LLC | Current |
Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Past | Accepting new patients | |
| Consulting Radiologists, LTD | Past |
Accepting new patients |
Locations
440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225
755 Crossroads Campus Dr NE
Ste 100
Buffalo, MN 55313
Phone (763) 684-6300
14000 Nicollet Ave
Ste 204
Burnsville, MN 55337
Phone (952) 898-2333
3960 Coon Rapids Blvd NW
Ste 200
Coon Rapids, MN 55433
Phone (763) 236-9236
5565 Blaine Ave
Ste 100
Inver Grove Heights, MN 55076
Phone (651) 241-9400
12000 Elm Creek Blvd N
Ste 310
Maple Grove, MN 55369
Phone (763) 416-7888
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
11850 Blackfoot St NW
Ste 180
Minneapolis, MN 55433
Phone (763) 795-1600
9055 Springbrook Dr NW
Minneapolis, MN 55433
Phone (763) 780-9155
8990 Springbrook Dr NW
Ste 140
Minneapolis, MN 55433
Phone (763) 792-1900
6545 France Ave S
Ste 115
Minneapolis, MN 55435
Phone (952) 893-1997
10705 Town Square Dr NE
Ste 100
Minneapolis, MN 55449
Phone (763) 236-5400
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141
333 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-8256
1110 Yankee Doodle Rd
Saint Paul, MN 55121
Phone (651) 454-3970
250 Thompson St
Saint Paul, MN 55102
Phone (651) 297-6504
2355 Highway 36 W
Ste 100
Saint Paul, MN 55113
Phone (651) 292-0000
7400 33rd St N
Ste 100
Saint Paul, MN 55128
Phone (651) 241-9240
4166 Lexington Ave N
Shoreview, MN 55126
Phone (651) 241-1306
4194 Lexington Ave N
Shoreview, MN 55126
Phone (651) 483-5461
150 Emerson Ave E
West St Paul, MN 55118
Phone (651) 241-1800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 7905 | MN | |
| Nurse Practitioner | 363L00000X | 7905 | MN | Yes |
Addresses
Primary practice location
2355 Hwy 36 W.
Ste. 100
Rochester, MN 55905-0001
Mailing address
2355 Hwy 36 W.
Ste. 100
Rochester, MN 55905-0001
Phone (651) 292-2000
Other names
- Kelly Johanna Huneke
Other providers in Rochester, MN
- Juan Camilo Diaz Soto
- Mansour Y Dib
- Michele Denice Dicarlo
- Brice Dick
- Michael David Dick
- Erin Dickerhoof
- Alison Dickinson
- Jake Joseph Dickinson
- Karen Dickinson
- Jacky Ann Dickman
All providers in Rochester, MN · 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 Jan 17, 2024. 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.